Relationship between acoustic characteristics of responsible plaques of carotid atherosclerosis based on SMI assessment and symptomatic ischemic cerebrovascular disease

WANG Haili; WANG Weifang; JIN Xiuli

doi:10.20258/j.cnki.1006-9011.2026.01.006

Abstract：Objective To evaluate the acoustic characteristics of carotid atherosclerotic culprit plaques based on superb mi-crovascular imaging(SMI),and to explore their relationship with symptomatic ischemic cerebrovascular disease(SICVD).Methods A total of 100 patients with ischemic cerebrovascular disease treated were selected as the research objects.According to whether there were symptoms of ischemic cerebrovascular disease,they were divided into asymptomatic group(n=32)and symptomatic group(n=68).The clinical data and the characteristics of carotid plaque were compared between the two groups.Multivariate Logistic regression analysis were used to analyze the influencing factors of SICVD.Generalized additive model(GAM)was used to analyze the relationship between the degree of carotid stenosis and the characteristics of each carotid plaque.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was used to evaluate the di-agnostic efficacy of each carotid plaque characteristics for different degrees of carotid artery stenosis in SICVD patients.The sen-sitivity,specificity,accuracy and AUC were compared to analyze the efficacy of each carotid plaque characteristics in the diagno-sis of SICVD under different degrees of carotid artery stenosis.Results Compared with the asymptomatic group,the symptom-atic group had significant increases in plaque thickness,plaque length,and neovascularization grade(all P<0.05).Multivariate Logistic regression analysis showed that plaque thickness and plaque length were risk factors for SICVD(P<0.05).GAM analysis showed that the degree of carotid stenosis and the characteristics of carotid plaque showed a curve relationship,and the differ-ence was statistically significant(all P<0.05).The degree of carotid stenosis was positively correlated with plaque thickness(F=4.474,P=0.011),plaque length(F=3.251,P=0.018)and neovascularization grade(F=3.936,P=0.013).ROC curve analysis showed that with the increase of the degree of carotid stenosis,the diagnostic efficacy of each carotid plaque characteristics for carotid stenosis increased significantly(all P<0.05).With the increase of the degree of carotid stenosis,the sensitivity,specific-ity,accuracy and AUC of single indicator and combined indicator of carotid plaque characteristics in the diagnosis of SICVD showed an increasing trend.Compared with single index,the AUC of combined index in the diagnosis of SICVD in the population with different degrees of carotid artery stenosis was significantly increased(all P<0.05).Conclusion The thickness,length and neovascularization grade of carotid atherosclerotic plaques diagnosed by SMI are risk factors for SICVD.With the aggravation of carotid stenosis,the combination of plaque characteristics can accurately identify patients with high risk of SICVD.