Evaluating the Efficacy of Atorvastatin on Patients with Carotid Plaque by an Innovative Ultrasonography

Zhu, Yicheng; Jiang, Xiaozhen; Bai, Quan; Deng, Shuhao; Zhang, Yuan; Zhang, Zhipeng; Jiang, Quan

doi:10.1016/j.jstrokecerebrovasdis.2018.11.027

Cited by 26 publications

(26 citation statements)

References 25 publications

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“…Clear cell renal cell carcinoma is the most common malignant solid tumor in the kidney [27]. Previous studies have shown that ring-like blood flow signals can appear around malignant tumors, which is the specific manifestation of malignant tumors [28,29]. e mechanism is that the pseudocapsule enclosing the tumors between malignant renal tumors and surrounding normal renal tissues is composed of a large number of fibrous tissues and capillaries [30].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Multimode Color Doppler Flow Imaging in the Diagnosis of Solid Renal Tumor

Shen

2021

Contrast Media & Molecular Imaging

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Background. Renal cell carcinoma is one of the most common malignant tumors in urinary system, seriously affecting people’s health and life. This study aimed to evaluate the clinical value of multi-mode color Doppler flow imaging for diagnosis of solid renal tumor. Methods. Sixty-six renal solid tumors from 63 patients were examined by color Doppler flow imaging (CDFI), power Doppler flow imaging (PDFI), superb microvascular imaging (SMI), and contrast-enhanced ultrasound (CEUS) before surgery. The diagnostic efficacy of the four methods was compared by determining blood flow grade and ring-like blood flow with Adler’s method. Chi-square test and Fisher’s test were performed to compare the results of sensitivity and specificity among four methods. Results. Statistically significant differences in blood flow grade and ring-like blood flow were observed between benign and malignant renal tumors as detected by SMI and CEUS ( P < 0.05), whereas no difference was found as detected by CDFI and PDFI ( P > 0.05). The results indicated that the sensitivity and specificity of SMI (82.46%, 88.89%) and CEUS (84.21%, 88.89%) were higher than those of CDFI (42.11%, 66.67%) and PDFI (47.37%, 77.78%). Compared with the abilities of CDFI and PDFI, SMI and CEUS can better display the micro-blood flow in the tumors and evaluate the blood flow grading, which indicated that SMI and CEUS may have high values in the differential diagnosis of benign and malignant solid renal tumors. Conclusion. SMI and CEUS can improve the sensitivity and specificity of the diagnosis of benign and malignant renal tumors and have a high application value.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Multimode Color Doppler Flow Imaging in the Diagnosis of Solid Renal Tumor

Shen

2021

Contrast Media & Molecular Imaging

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“…The result indicated that a value of plaque thickness of 2.25 mm was the best cutoff value for predicting SMI evidence of moderate to marked neovascularzation. To the best of our knowledge (10–12, 18), this is the first study in which SMI findings of intraplaque neovascularization were correlated to the subjects' clinical histories, and also the study with the largest sample for neovascularization detection by SMI until now. It has been shown that intraplaque neovascularization is a frequently studied carotid plaque feature since it has been described to be associated with plaque instability (19–22).…”

Section: Discussionmentioning

confidence: 96%

Assessment of Carotid Intraplaque Neovascularization Using Superb Microvascular Imaging in High Risk of Stroke Individuals: Results From a Community-Based Study

et al. 2019

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Background: Improved stroke risk stratification may improve stroke prevention. We aimed to study the value of a novel Doppler method, superb microvascular imaging (SMI), in correlating plaque thickness and evidence of intra-plaque neovascularization with a history stroke and TIA involving any cerebrovascular territory among community residents considered at high stroke risk.Methods: We selected residents aged at least 40 years from the Donghuashi community in China who had at least three stroke risk factors (including a history of stroke or TIA) and carotid plaque thickness of at least 1.5 mm (but without heavy calcification) and no history of carotid endarterectomy or stenting. In this cross-sectional study, each subject underwent carotid plaque examination with standard ultrasound and SMI. SMI evidence of plaque neovascularization was categorized as none or mild (Grade 1) or moderate or marked (Grade 2) and correlated with past history of stroke or TIA.Results: A total of 131 individuals (mean age 69 ± 8 years, 63% male) met the study inclusion criteria. SMI revealed no or mild neovascularization in 74 subjects (56.5%) and moderate or marked neovascularization in 57 subjects (43.5%). Subjects with moderate or marked neovascularization were more likely to have a history of any territory stroke or TIA, 43.9 vs. 17.6% (P = 0.001). Multivariate logistic regression analyses showed a thicker plaque (odds ratio: 2.272, 95% CI: 1.351–3.822, P = 0.002) and a history of stroke or TIA (odds ratio: 4.017, 95% CI: 1.719–9.387, P = 0.001) significantly correlated with evidence of moderate to marked intra-plaque neovascularization.Conclusions: Moderate to marked intraplaque neovascularization detected by SMI was more likely in subjects with a history of any territory stroke or TIA or thicker plaque. This indicates a potential new role of SMI in stratifying future risk of stroke or other arterial disease complications.

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“…This promotes plaque instability and represents an important source of free cholesterol from red blood cells membranes, with consequent macrophage infiltration and necrotic core enlargement [10,11]. CEUS and SMI have shown great promise in the visualization of intraplaque neovascularization [12,14,[30][31][32][33][34][35], and studies have reported good correlation between IPN assessment by CEUS and micro-vessel density at histology [12,36]. Previous studies also demonstrated a good consistency between assessment of IPN by CEUS and SMI.…”

Section: Discussionmentioning

confidence: 99%

Advanced ultrasound methods in assessment of carotid plaque instability: a prospective multimodal study

et al. 2020

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Background: A significant proportion of ischemic strokes are caused by emboli from atherosclerotic, unstable carotid artery plaques. The selection of patients for endarterectomy in current clinical practice is primarily based on the degree of carotid artery stenosis and clinical symptoms. However, the content of the plaque is known to be more important for stroke risk. Intraplaque neovascularization (IPN) has recently emerged as a possible surrogate marker for plaque instability. Neo-microvessels from the adventitial vasa vasorum grow into the full thickness of the vessel wall in an adaptive response to hypoxia, causing subsequent intraplaque haemorrhage and plaque rupture. Conventional ultrasound cannot detect IPN. Contrast-enhanced ultrasound and Superb Microvascular Imaging (SMI), have, however, shown promise in IPN assessment. Recent research using Shear Wave Elastography (SWE) has also reported reduced tissue stiffness in the artery wall (reduced mean Young's modulus) in unstable compared to stable plaques. The purpose of this study is to identify unstable carotid artery plaques at risk of rupture and future ischemic stroke risk using multimodal assessments. Methods: Forty five symptomatic and 45 asymptomatic patients > 18 years, with > 50% carotid stenosis referred to Oslo University Hospital ultrasound lab will be included in this ongoing project. Patients will undergo contrast enhanced ultrasound, SMI, carotid-MRI and PET-(18 F-FDG). Contrast enhanced ultrasound will be analyzed semiquantitatively (5-levels visual classification) and quantitatively by plotting time-intensity curve analyses to obtain plaque peak contrast enhancement intensity. Plaques removed at carotid endarterectomy will be assessed histologically and the number of microvessels, areas of inflammation, granulation, calcification, lipid and fibrosis will be measured. Discussion: This multimodality study will primarily provide information on the clinical value of advanced ultrasound methods (SMI, SWE) for the detection of unstable carotid artery plaque in comparison with other methods including contrast-enhanced ultrasound, carotid-MRI and PET-(18 F-FDG) using histology as the gold standard. Secondly, findings from the methods mentioned above will be related to cerebrovascular symptoms, blood tests (leukocytes, CRP, ESR, lipoproteins and inflammatory markers) and cardiovascular risk factors at inclusion and at 1year follow-up. The overall aim is to optimize detection of plaque instability which can lead to better preventive decisions and reduced stroke rate.

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Evaluating the Efficacy of Atorvastatin on Patients with Carotid Plaque by an Innovative Ultrasonography

Cited by 26 publications

References 25 publications

Evaluation of Multimode Color Doppler Flow Imaging in the Diagnosis of Solid Renal Tumor

Evaluation of Multimode Color Doppler Flow Imaging in the Diagnosis of Solid Renal Tumor

Assessment of Carotid Intraplaque Neovascularization Using Superb Microvascular Imaging in High Risk of Stroke Individuals: Results From a Community-Based Study

Advanced ultrasound methods in assessment of carotid plaque instability: a prospective multimodal study

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