The value of high-resolution vessel wall imaging combined with contrast-enhanced ultrasound in the diagnosis of vul-nerable carotid plaques in patients with carotid atherosclerosis

SHAN Jiguang; LIU Fangzhi; LIU Cuijie

doi:10.20258/j.cnki.1006-9011.2025.12.005

Abstract：Objective To explore the value of high-resolution vessel wall imaging(HR-VWI)combined with contrast-enhanced ultrasound(CEUS)in the diagnosis of vulnerable carotid plaques in patients with carotid atherosclerosis.Methods Totally,76 patients with carotid atherosclerosis who underwent carotid endarterectomy were divided into vulnerable group(42 cases)and stable group(34 cases)according to the plaque nature of digital subtraction angiography(DSA).Patients in both groups under-went HR-VWI and CEUS examinations.Kappa test was used to analyze the consistency between HR-VWI,CEUS examination re-sults and DSA examination results.ROC curve was used to analyze the efficacy of HR-VWI and CEUS in diagnosing vulnerable plaques.Results The differences in hcy,hdl-c,and ldl-c between the two groups were statistically significant(P<0.05).Mul-tivariate Logistic regression analysis showed that high HCY,low HDL-C,and high LDL-C were risk factors for the formation of vulnerable carotid plaques(all P<0.05).The detection rate of vulnerable plaques in DSA examination was 55.26%(42/76),while,the detection rates of vulnerable plaques in HR-VWI and CEUS examinations were 53.95%(41/76)and 50.00%(38/76),respectively.The detection rate of vulnerable plaques in HR-VWI combined with CEUS examination was 59.21%(45/76).The detection rates of the four methods were compared,and all P values were greater than 0.05.HR-VWI and CEUS diagnosis of vulnerable plaques showed moderate consistency with DSA examination(Kappa values of 0.443 and 0.421,respectively),while,HR-VWI combined with CEUS diagnosis of vulnerable plaques showed high consistency with DSA examination(Kappa value of 0.758).The AUC of HR-VWI and CEUS in diagnosing vulnerable plaques was 0.722 and 0.713,respectively,with sen-sitivities of 73.81%and 69.05%,and accuracies of 72.37%and 71.05%,respectively.The AUC,sensitivity,and accuracy of the combined diagnosis of the two were 0.876,92.86%,and 88.16%,respectively.The combined diagnostic efficacy was the highest(all P<0.05).Conclusion The value of HR-VWI combined with CEUS in diagnosis of vulnerable plaque is better than that of both alone.