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.

超微血管成像和超声造影对颈动脉粥样硬化斑块内新生血管的评估价值

目的探讨超微血管成像(SMI)和超声造影(CEUS)评估颈动脉粥样硬化斑块内新生血管的应用价值。方法选择2017年9月至2019年5月在洛阳市中心医院收治的40例行颈动脉内膜剥脱术患者为研究对象,患者均行术前颈动脉斑块SMI、CEUS检查及术后斑块组织病理学分析,比较SMI、CEUS及微血管密度(MVD)法检测颈动脉斑块内新生血管的检出率,并分析SMI、CEUS评估颈动脉斑块内新生血管丰富程度与MVD的相关性。结果40例患者中,SMI检出颈动脉斑块内新生血管31例(77.5%),CEUS检出颈动脉斑块内新生血管33例(82.5%),MVD法检出颈动脉斑块内新生血管37例(92.5%);SMI、CEUS检测颈动脉斑块内新生血管的检出率与MVD法比较差异无统计学意义(χ^2=3.530、1.830,P>0.05)。SMI评估新生血管丰富程度中0、1、2、3级患者的MVD分别为(5.00±3.84)、(13.70±3.59)、(21.82±4.02)、(30.80±3.74)个·mm^-2;CEUS评估新生血管丰富程度中0、1、2、3级分别为7、8、11、14例,其MVD分别为(5.71±5.65)、(13.00±4.44)、(18.82±4.58)、(28.64±4.88)个·mm^-2;不同程度SMI、CEUS分级患者的MVD均呈递增趋势,两两比较差异均有统计学意义(P<0.05)。SMI、CEUS评估颈动脉斑块新生血管丰富程度与MVD呈正相关(r=0.911、0.883,P<0.01)。结论SMI、CEUS技术能够准确评估颈动脉粥样硬化斑块内新生血管情况,为临床评估患者颈动脉斑块的稳定性提供有价值的信息。

无穷的魅力和些微的瑕斑——关于毛泽东诗词的再认识

到目前为止 ,对毛泽东诗词的研究存在着一个偏向和两个不足 ,一个偏向是尽为褒词 ,个个都“欲与天公试比高”。两个不足是对文本的具体而深入的分析十分不够 ,如《菩萨蛮·大柏地》在色彩之调动和构图之布局上的成就 ,数部主要析释著作 ,均未作艺术探赏 ;而作品的不足之处上述专著也只字未提。毛泽东诗词研究应在这些方面进行必要的补课。

细柳编织

手艺精湛的李细柳坦言自己不擅长文字和图像的表达,她说,小时候家庭条件艰苦,只读了几年书,更没有学过绘画,所有的作品都是在没有设计好针法和绘制好图稿情况下,一边想一边钩出来的,想象力也是与儿时的生活有关。排行老幺的李细柳从小就古灵精怪,活泼好动,漫山遍野的跑,对一切事物都充满了好奇。有一次母亲带她回家乡探望祖母,祖母住在海边,每天都会搬张竹椅坐在海边做女红,祖母最喜爱钩编衣物,那天她正聚精会神地钩编着一件鲜红色的毛衣,没有注意到原本在海边玩耍奔跑的李细柳已蹲坐在祖母身边看了半天,那是她第一次见到钩针,对祖母娴熟的钩编手法赞叹不已。