Relationship between Contrast-Enhanced Ultrasound Characteristics of Carotid Plaques, Carotid Stenosis Severity, and Transient Ischemic Attack

Abstract

Introduction

To investigate the correlation between contrast-enhanced ultrasound (CEUS) characteristics of carotid plaques, degree of carotid stenosis, and transient ischemic attack (TIA), and to establish a risk stratification model based on a preventive medicine framework for guiding clinical interventions.

Method

A retrospective study was conducted on 112 patients with carotid atherosclerosis from January 2020 to June 2023, categorized into mild (<50%), moderate (50%-70%), and severe (>70%) stenosis groups. CEUS was used to evaluate plaque enhancement patterns (homogeneous/heterogeneous) and intraplaque neovascularization grades (0-III). Associations with stenosis severity and TIA incidence were analyzed by integrating preventive medicine risk factors (blood pressure, lipid levels, smoking history).

Results

The severe stenosis group showed significantly higher proportions of heterogeneous enhancement (78.3% vs. 42.1%) and grade III neovascularization (65.2% vs. 15.8%) compared to the mild group (P<0.01). Multivariate logistic regression identified heterogeneous enhancement (OR=3.12, 95%CI 1.45-6.71) and grade III neovascularization (OR=4.85, 95%CI 2.33-10.09) as independent risk factors for TIA. ROC analysis demonstrated that combining CEUS parameters with preventive medicine indicators (Framingham Risk Score) improved the AUC for TIA prediction to 0.91 (sensitivity 86.7%, specificity 83.2%).

Discussion

CEUS characteristics effectively assess carotid plaque vulnerability and correlate with stenosis severity and TIA occurrence, providing imaging evidence for early clinical intervention. The established "imaging-clinical" risk stratification model (low, intermediate, high risk) provides guidance for preventive medicine practice.