3.0T HRMRI for the study of carotid artery plaque / 中华普通外科杂志

Objective To evaluate 3.0T high resolution magnetic resonance (HRMRI) scanner for determining the carotid plaque vulnerability.Method Fifteen inpatients with carotid plaque stenosis were enrolled.The stenosis rate confirmed by Doppler ultrasound was 50％-99％ (excluding those with 100％ occlusion of the carotid artery).Head and neck coil 24 (HNC 24) was used for extracranial carotid artery plaque scan.Results There was no statistically significant difference between pathology and 3.0T HRMRI in the detemination of carotid plaque composition (P =0.546)and carotid artery stenosis rate (P =0.289).HRMRI showed good consistency with pathology in detecting intraplaque hemorrhage (Kappa =0.816) and lipid necrosis core (Kappa =0.771),and normal consistency with pathology in detecting calcification (Kappa =0.674).The highest sensitivity (87.23％) and the highest specificity (97.77％) of intraplaque hemorrhage were detected for the core of lipid necrosis.Conclusion The 3.0T high resolution magnetic resonance detailed analysis of extracranial carotid plaque composition,morphology,luminal stenosis,plaque lumen and wall area data for assessment.

The value of plasma ADAMTS4 in evaluating the stability of carotid plaque / 中华普通外科杂志

Objective To explore the relationship between the level of plasma ADAMTS4 and the vulnerability of carotid atherosclerotic plaque in patients with carotid artery stenosis and the clinical value of evaluating the vulnerability of the carotid atherosclerotic plaque.Methods 60 patients with carotid artery stenosis were divided into stable plaque group and vulnerable plaque group according to the histopathological typing after carotid endarterectomy (CEA).30 patients who had atherosclerosis but no carotid plaque formation served as control.Using ELISA to measure the level of plasma ADAMTS4.Results The level of plasma ADAMTS4 was significantly higher in the vulnerable-plaque group (112.74 ± 17.47) ng/ml compared with the stable plaque group (56.67 ± 22.14)ng/ml and the control group (56.67 ± 22.14)ng/ ml,P ＜ 0.001.Logistic analysis showed that high level of plasma ADAMTS4 was risk factor for vulnerability of carotid atherosclerotic plaque (P ＜ 0.05,OR =8.240,95 ％ CI:1.512-22.915).ROC curve showed that ADAMTS4 =100.935 ng/ml could accurately predict significant vulnerability with accuracy of 94.3％.Conclusion ADAMTS4 is an effective,sensitive and non-invasive biomarker to evaluate the vulnerability of carotid atherosclerotic plaque.