Value of superb micro-vascular imaging in predicting ischemic stroke in patients with carotid atherosclerotic plaques

BACKGROUND Unstable carotid atherosclerotic plaques are prone to cause ischemic stroke.Contrast-enhanced ultrasound(CEUS) is the primary method of assessing plaque stability, but CEUS cannot be a method for screening for unstable plaque. The emergence of superb micro-vascular imaging(SMI) offers the possibility of clinically screening for unstable plaque AIM To investigate the value of SMI in predicting ischemic stroke in patients with carotid atherosclerotic plaques.METHODS Patients with carotid atherosclerotic plaques(luminal stenosis of 50%-70%) were enrolled into the present study. All patients received conservative medication.The patient's clinical baseline data, serological data, CEUS and SMI data were analyzed. All patients underwent a 3-year follow-up. The follow-up endpoint was the occurrence of ischemic stroke and patients were divided into stroke group and non-stroke group according to whether the prognosis occurred or not.Subsequently, the difference in clinical data was compared, the correlation of SMI and CEUS was analyzed, and multiple Cox regression and receiver operating characteristic curve were applied to investigate the value of SMI and CEUS in predicting cerebral arterial thrombosis in three years.RESULTS In this study, 43 patients were enrolled in the stroke group and 82 patients were enrolled in the non-stroke group. Cox regression revealed that SMI level(P =0.013) and enhancement intensity(P = 0.032) were the independent factors influencing ischemic stroke. There was a positive correlation between SMI level and enhancement intensity(r = 0.737, P = 0.000). The area under curve of SMI level predicting ischemic stroke was 0.878. The best diagnostic point was ≥ level Ⅱ, and its sensitivity and specificity was 86.05% and 79.27%. The area under curve of enhancement intensity predicting ischemic stroke was 0.890. The best diagnostic point was 9.92 db, and its sensitivity and specificity was 88.37% and89.02%. As the SMI level gradually increased, the incidence of ischemic stroke increased gradually(X^2 = 108.931, P = 0.000).CONCLUSION SMI can be used as a non-invasive method of screening for unstable plaques and may help prevent ischemic stroke.

Role of shear wave elastography in the evaluation of the treatment and prognosis of supraspinatus tendinitis

BACKGROUND Supraspinatus tendinitis recurs easily after treatment.One of the main reasons is the lack of objective tools for the efficacy evaluation.Shear wave elastography(SWE)can quantitatively analyze the tissue elasticity of region of interest by measuring the Young’s modulus(YM)value.AIM To explore the role of SWE in the efficacy and prognostic evaluation of supraspinatus tendinitis.METHODS Eighty-seven patients with supraspinatus tendinitis treated in Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences were recruited.Another 30 healthy volunteers were enrolled as the control group.The visual analogue scale(VAS)and Constant-Murley Score(CMS)were recorded before treatment.All participants were scanned by SWE scan,and the YM value of the region of interest were recorded.Spearman correlation analysis was performed on YM values with VAS and CMS.Univariate repeated measures analysis of variance was used to calculate the changing trend of VAS,CMS and SWE under different treatment courses.After treatment,the patients were further grouped based on who achieved significantly effective and curative treatment.The patients in the continued treatment group continued to receive treatment according to the YM value,and the remaining patients who stopped receiving treatment were included in the stopped treatment group.All patients were followed up for 1 year,and the difference in recurrence rates between the continued treatment group and the stopped treatment group were compared.RESULTS The SWE images of supraspinatus muscle in healthy volunteers were mainly blue,while those of patients with supraspinatus tendinitis showed regional red and green areas.The average YM value of the supraspinatus muscle in healthy volunteers was 26.12±4.03 kPa.The average YM value of patients with supraspinatus muscle was greater than that of healthy volunteers(average YM=60.61±11.53 kPa,t=26.344,P<0.001).The YM value was positively correlated with VAS(r=0.564,P<0.001)and negatively correlated with CMS(r=-0.411,P<0.001).The changes of VAS and CMS were the most obvious in course 1 and then decreased gradually.The degree of change in YM values was similar in different courses.After a 1-year follow-up,the cumulative relapse-free rate in the continued treatment group was 91.43%,which was significantly higher than that in the stopped treatment group(64.71%,X2=7.379,P=0.007).CONCLUSION SWE can objectively indicate the severity of supraspinatus tendinitis.Using the YM value as a criterion for curative effect may reduce the recurrence rate.

Crust–mantle interaction recorded by Early Cretaceous volcanic rocks within the southern margin of the North China Craton

This study presents new geochronological and geochemical data for Early Cretaceous volcanic rocks in the southern margin of the North China Craton(NCC),to discuss the crust–mantle interaction.The studied rocks include pyroxene andesites from Daying Formation,hornblende andesites and andesites from Jiudian Formation,and rhyolites from a hitherto unnamed Formation.These rocks formed in Early Cretaceous(138–120 Ma),with enrichment in light rare earth elements(REE),depletion in heavy REE and arc-like trace elements characteristics.Pyroxene andesites show low SiO_(2) contents and enriched Sr–Nd–Pb–Hf isotopic compositions,with orthopyroxene phenocryst and Paleoproterozoic(2320–1829 Ma)inherited zircons,suggesting that they originated from lithospheric mantle after metasomatism with NCC lower crustal materials.Hornblende andesites have low SiO_(2) contents and high Mg#(Mg#=100 Mg/(Mg+Fe^(2+)))values,indicating a lithospheric-mantle origin.Considering the distinct wholerock Sr isotopic compositions we divide them into two groups.Among them,the low(^(87)Sr/^(86)Sr)iandesites possess amount inherited Neoarchean to Neoproterozoic(2548–845 Ma)zircons,indicating the origin of lithospheric mantle with addition of Yangtze Craton(YC)and NCC materials.In comparison,the high(^(87)Sr/^(86)Sr)iandesites,with abundant Neoarchean–Paleozoic inherited zircons(3499–261 Ma),are formed by partial melting of lithospheric mantle with incorporation of NCC supracrustal rocks and YC materials.Rhyolites have extremely high SiO_(2)(77.63–82.52 wt.%)and low total Fe_(2)O_(3),Cr,Ni contents and Mg#values,combined with ancient inherited zircon ages(2316 and 2251 Ma),suggesting an origin of NCC lower continental crust.Considering the presence of resorption texture of quartz phenocryst,we propose a petrogenetic model of’crystal mushes’for rhyolites prior to their eruption.These constraints record the intense crust–mantle interaction in the southern margin of the NCC.Given the regional data and spatial distribution of Early Cretaceous rocks within NCC,we believe that the formation of these rocks is related to the contemporaneous far-field effect of the Paleo-Pacific Plate.