Predictive value of real-time three-dimensional ultrasound plaque quantitative parameters combined with MRI fea-tures on the risk of cerebral infarction in patients with carotid atherosclerosis

WANG Wenqing; WANG Heming; WANG Lijun

doi:10.20258/j.cnki.1006-9011.2025.08.008

Abstract：Objective To analyze the predictive value of real-time three-dimensional ultrasound(3DUS)vascular plaque quantitative parameters combined with magnetic resonance imaging(MRI)characteristics in predicting the risk of cerebral in-farction(CI)in patients with carotid atherosclerosis(CAS).Methods A total of 110 CAS patients who underwent 3DUS vascu-lar plaque quantitative analysis(VPQ)and MRI examinations were selected.Patients were divided into a CI group of 37 cases and a non CI group of 73 cases based on whether CI occurred.The quantitative parameters of 3DUS vascular plaques in terms of-plaque volume(PV),plaque thickness(PT),vascular lumen area(LA),standardized wall index(NWI),and median gray scale(GSM)and MRI features such as centripetal/eccentric plaques,stable/unstable plaques between two groups were com-pared.The multiple logistic regression analysis was used to investigate the relationship between quantitative parameters and MRI features of 3DUS vascular plaques and the occurrence of CI in patients with CAS.The receiver operating characteristic(ROC)curves were drawn and the predictive efficacy of 3DUS vascular plaque quantitative parameters combined with MRI features for CI in patients with CAS were analyzed.Results The NWI of the CI group was higher than that of the non CI group,the GSM was lower than that of the non CI group,and the proportion of eccentric plaques and unstable plaques was higher than that of the non CI group(P<0.05).Multivariate logistic regression analysis showed that increased NWI,eccentric plaques,and unstable plaques were risk factors for CI in patients with CAS(OR>1,P<0.05).GSM increase was a protective factor for CI in CAS pa-tients(OR<1,P<0.05).The ROC curve showed that NWI,GSM,and the AUC of predicting CI in patients with CAS by combin-ing plaque type and plaque properties was 0.965,which was higher than the AUC predicted by each indicator alone by Delong test(P<0.05).Conclusion The real-time 3DUS vascular plaque quantitative parameters combined with MRI features have high value in predicting the occurrence of CI in patients with CAS,which can be used as a clinical assessment plan for the risk of CI.