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Assessment of carotid plaque neovascularization by contrast-enhanced ultrasound and high sensitivity C-reactive protein test in patients with acute cerebral infarction: a comparative study

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Abstract

Vulnerable carotid plaque easily ruptures and causes cerebral infarction. Plaque inflammation and neovascularization have both been shown as important characteristics in vulnerable plaque. We assessed neovascularization within carotid plaque using contrast-enhanced ultrasound, and also assessed inflammation, using high sensitivity C-reactive protein (hs-CRP) testing, in acute cerebral infarction patients. A total of 106 patients with acute cerebral infarction and 40 controls were enrolled in the study. All subjects had been previously found to have carotid atherosclerotic plaques, and the plaques were classified as soft plaque, hard plaque, mixed plaque, and calcified plaque, using carotid artery ultrasound. Contrast-enhanced ultrasound was performed on the plaques for quantitative analysis and hs-CRP levels were measured. The results showed that plaque enhancement was present in 81.1 % of cerebral infarction patients and 40.0 % of controls. The contrast parameters for cerebral infarction patients were significantly different from controls. For cerebral infarction patients, soft plaque showed the highest enhanced percentage, 95.1 %, with contrast parameters significantly different to other types of plaque. The hs-CRP levels of enhanced cerebral infarction patients were higher than in non-enhanced patients. Correlation analysis in cerebral infarction patients showed that hs-CRP levels were closely related to the contrast parameters. Acute cerebral infarction patients showed intense contrast enhancement and inflammation in carotid plaque, and different types of plaque had various degrees of enhancement, suggesting that contrast-enhanced ultrasound and hs-CRP might be used for plaque risk stratification.

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Acknowledgments

This work was supported by a grant from Jiading Health Bureau for Scientific Research Projects, Shanghai, China (Grant No. QNKYJJ2011-12-01). We are grateful to the radiologists and technicians at Jiading Central Hospital involved in work related to this research area, for their technical assistance and helpful discussions. We thank LetPub (www.letpub.com) for its linguistic assistance during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Ultrasound, Jiading Central Hospital, No.1 Chengbei Road, Jiading District, Shanghai, People’s Republic of China

    Rong Xu, Lin Jin, Min Lu & Yingchun Wang

  2. Department of Radiology, Jiading Central Hospital, No.1 Chengbei Road, Jiading District, Shanghai, People’s Republic of China

    Xiaohua Yin

  3. Department of Laboratory, Jiading Central Hospital, No.1 Chengbei Road, Jiading District, Shanghai, People’s Republic of China

    Weixin Xu

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  1. Rong Xu
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  2. Xiaohua Yin
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  3. Weixin Xu
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  4. Lin Jin
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  5. Min Lu
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  6. Yingchun Wang
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Correspondence to Rong Xu.

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Xu, R., Yin, X., Xu, W. et al. Assessment of carotid plaque neovascularization by contrast-enhanced ultrasound and high sensitivity C-reactive protein test in patients with acute cerebral infarction: a comparative study. Neurol Sci 37, 1107–1112 (2016). https://doi.org/10.1007/s10072-016-2557-2

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  • DOI: https://doi.org/10.1007/s10072-016-2557-2

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