ABSTRACT
Objective@#To investigate the correlation between carotid plaque vulnerability and MRI imaging markers and overall burden of cerebral small vessel disease (CSVD).@*Methods@#From January 2018 to December 2018, patients with carotid plaque thickness ≥2 mm admitted to the Brain Disease Center, the Affiliated Hospital of Nanjing University of Chinese Medicine was enrolled prospectively. Contrast-enhanced ultrasonography (CEUS) was used to evaluate the vulnerability of carotid plaque. All patients underwent head MRI. Lacunar infarction, white matter hyperintensities, cerebral microbleeds and enlarged perivascular space were recorded and the overall burden of CSDV was calculated. Binary multivariate logistic regression analysis was used to determine the correlation between carotid vulnerable plaque and various imaging markers of CSVD. Ordinal multivariable logistic regression analysis was used to determine the correlation between the carotid vulnerable plaques and the overall burden of CSCD.@*Results@#A total of 112 patients were included, including 61 (54.5%) in vulnerable plaque group and 51 (45.5%) in non-vulnerable plaque group. There were significant differences in the proportion of diabetes mellitus (49.2% vs. 19.6%; χ2=10.580, P<0.001), lacunar infarction (54.1% vs. 31.4%; χ2=5.829, P=0.016) and white matter hyperintensities (41.0% vs. 19.6%; χ2=5.907, P=0.015) between the vulnerable plaque group and the non-vulnerable plaque group. Multivariate logistic regression analysis showed that after adjusting for age, gender, hypertension, diabetes, and hyperlipidemia, there was a significant independent correlation between lacunar infarction (odds ratio [OR] 2.776, 95% confidence interval [CI] 1.139-6.765; P=0.025) and white matter hyperintensities (OR 3.969, 95% CI 1.465-10.753; P=0.007) and carotid vulnerable plaque. There were significant differences in age (F=4.275, P=0.003), past stroke history (χ2=11.100, P=0.025) and vulnerable plaque (χ2=9.829, P=0.043) in different CSVD burden groups. The overall burden of CSVD increased significantly with the increase of CEUS grade of carotid plaque (χ2=28.525, P=0.005). Ordinal multivariable logistic regression analysis showed that after adjusting for age, gender, hypertension, diabetes, coronary heart disease, stroke history, and smoking, there was still a significant independent correlation between the overall burden of CSVD and vulnerable plaques (OR 3.753, 95% CI 1.678-8.392; P=0.001).@*Conclusions@#Carotid vulnerable plaques were independently associated with lacunar infarction, white matter hyperintensities, and total burden of CSVD.
ABSTRACT
Objective To investigate the correlation between carotid plaque vulnerability and MRI imaging markers and overall burden of cerebral small vessel disease (CSVD).Methods From January 2018 to December 2018,patients with carotid plaque thickness ≥2 mm admitted to the Brain Disease Center,the Affiliated Hospital of Nanjing University of Chinese Medicine was enrolled prospectively.Contrast-enhanced ultrasonography (CEUS) was used to evaluate the vulnerability of carotid plaque.All patients underwent head MRI.Lacunar infarction,white matter hyperintensities,cerebral microbleeds and enlarged perivascular space were recorded and the overall burden of CSDV was calculated.Binary multivariate logistic regression analysis was used to determine the correlation between carotid vulnerable plaque and various imaging markers of CSVD.Ordinal multivariable logistic regression analysis was used to determine the correlation between the carotid vulnerable plaques and the overall burden of CSCD.Results A total of 112 patients were included,including 6l (54.5％) in vulnerable plaque group and 51 (45.5％) in non-vulnerable plaque group.There were significant differences in the proportion of diabetes mellitus (49.2％ vs.19.6％;x2 =10.580,P ＜ 0.001),lacunar infarction (54.1％ vs.31.4％;x2 =5.829,P =0.016) and white matter hyperintensities (41.0％ vs.19.6％;x2 =5.907,P=0.015) between the vulnerable plaque group and the non-vulnerable plaque group.Multivariate logistic regression analysis showed that after adjusting for age,gender,hypertension,diabetes,and hyperlipidemia,there was a significant independent correlation between lacunar infarction (odds ratio [OR] 2.776,95％ confidence interval [CI] 1.139-6.765;P =0.025) and white matter hyperintensities (OR 3.969,95％ CI 1.465-10.753;P =0.007) and carotid vulnerable plaque.There were significant differences in age (F =4.275,P =0.003),past stroke history (x2 =11.100,P =0.025) and vulnerable plaque (x2 =9.829,P=0.043) in different CSVD burden groups.The overall burden of CSVD increased significantly with the increase of CEUS grade of carotid plaque (x2 =28.525,P =0.005).Ordinal multivariable logistic regression analysis showed that after adjusting for age,gender,hypertension,diabetes,coronary heart disease,stroke history,and smoking,there was still a significant independent correlation between the overall burden of CSVD and vulnerable plaques (OR 3.753,95％ CI 1.678-8.392;P =0.001).Conclusions Carotid vulnerable plaques were independently associated with lacunar infarction,white matter hyperintensities,and total burden of CSVD.
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Objective To investigate and explore the awareness and willingness of breast cancer screening between Han and Mongolian women in Ordos, Inner Mongolia Autonomous Region, and to analyze the influence factors. Methods The patients answered investigation questionnaires face to face, and the content of questionnaire included demographic information, breast cancer awareness and relevant affecting factors on the awareness and willingness. Results 11162 (88.2 %) Han women and 1495 (11.8 %) Mongolian women were enrolled in the survey, with the average age of (45.4 ±7.1) years old and (45.4 ±6.8) years old. The education level (high school and above) of Han women was lower than that of Mongolian women [4456 women (40.0%) vs. 750 women (50.2%), χ2= 57.041, P< 0.001]. The Main way to delivery information on breast cancer screening in Han and Mongolian women was from their family members or friends [5002 women (44.9%) vs. 688 women (46.1%),χ2=40.699, P<0.001]. The proportions of never attending screening in the Han and Mongolian women were 41.7 % (4640 women) and 45.9 % (683 women), respectively (χ2=14.075, P=0.001). The breast self-examination rate of Han women were higher than that of Mongolian [71.1 % (7926 women) vs. 58.5 % (872 women), χ2= 98.466, P< 0.001]. According to logistics regression analysis, the cognitive level of women with high education level and breast disease history was higher (all P<0.001). Conclusions The cognitive level of breast cancer screening in Han women is better than that in the Mongolian, however, the overall level are low. It is necessary to strengthen the propaganda and education, and to encourage women to actively participate in breast cancer screening.