Transcranial Color-Coded Sonography for the Detection of Cerebral Veins and Sinuses and Diagnosis of Cerebral Venous Sinus Thrombosis.

This study aimed to determine the detection rate of transcranial color-coded sonography (TCCS) of cerebral veins and sinuses and to explore the diagnostic accuracy of TCCS for straight sinus (SS) and transverse sinus (TS) thromboses. The detection rates of cerebral veins and sinuses using TCCS and contrast-enhanced TCCS (CE-TCCS) were analyzed. The diagnostic accuracy of CE-TCCS was evaluated. Median time from symptoms to CE-TCCS was 10 (range, 1-150) d. The detection rate of bilateral basal veins of Rosenthal was 100% by CE-TCCS, followed by right TS (91.89%), SS (88.12%), left TS (74.59%) and vein of Galen (70.27%). Compared with magnetic resonance imaging/magnetic resonance venography, CE-TCCS showed 100% sensitivity and 96.3% specificity for SS thrombosis, 100% and 100% for right TS thrombosis and 100% and 94.4% for left TS thrombosis. In conclusion, CE-TCCS shows high identification rates of cerebral veins and sinuses and a high diagnostic accuracy for SS and TS thrombosis.

The correlation between calcification in carotid plaque and stroke: calcification may be a risk factor for stroke.

BACKGROUND: There are few studies on the relationship between calcified plaques and stroke by ultrasound. We investigated the association between calcification in carotid plaque and stroke by analyzing the different characteristics of calcification and neovascularization distribution in heterogeneous plaques by both two-dimensional and contrast-enhanced ultrasound (CEUS). METHODS: A total of 69 patients who were about to undergo carotid endarterectomy were selected between January 2016 and December 2017. Thirty-eight patients with cerebral ischemia were placed in the symptomatic group (amaurosis, TIA and no disability in the previous 6 months), and the other 31 patients, who were asymptomatic, were placed in the asymptomatic group. Two-dimensional ultrasound and CEUS were used to detect the calcification distribution characteristics and neovascularization in the plaques of all subjects. The differences of the calcification location, shape, quantity, and enhancement in the plaques were compared between the two groups. RESULTS: There was no significant difference in calcification location between the two groups (P > 0.05). The symptomatic group had more nodular calcification but less strip calcification compared with the asymptomatic group (both P < 0.05). There was no significant difference in mixed morphologic calcification between the two groups (P > 0.05). The symptomatic group had a higher calcification quantity (P < 0.05). The symptomatic group exhibited more fibrous cap fracture and intra-plaque hemorrhage in H&E staining (χ2 = 17.133, P < 0.001, χ2 = 10.003, P = 0.003) and higher CD31 expression (t = 7.584, P = 0.000). CONCLUSIONS: The quantity and shape of the calcification, and the presence of neovascularization adjacent to the calcification have certain effects on the stability of plaques. Multiple calcifications, nodular calcification, and neovascularization near calcification may cause plaque rupture and therefore might be risk factors for stroke. Our results suggest that the joint use of two-dimensional ultrasound and CEUS can provide comprehensive information on plaques to assess their stability.