Value of Multimodal Ultrasonography Combined with Clinical Indicators in Predicting the Progression of Ischemic Stroke

Li DONG; Rongping NING; Qiongyi XIAO

doi:10.12259/j.issn.2095-610X.S20240325

Volume 45 Issue 3

Mar. 2024

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2024 > 45(3): 166-173

Li DONG, Rongping NING, Qiongyi XIAO. Value of Multimodal Ultrasonography Combined with Clinical Indicators in Predicting the Progression of Ischemic Stroke[J]. Journal of Kunming Medical University, 2024, 45(3): 166-173. doi: 10.12259/j.issn.2095-610X.S20240325

Citation:

Li DONG, Rongping NING, Qiongyi XIAO. Value of Multimodal Ultrasonography Combined with Clinical Indicators in Predicting the Progression of Ischemic Stroke[J]. Journal of Kunming Medical University, 2024, 45(3): 166-173. doi: 10.12259/j.issn.2095-610X.S20240325

Citation:

PDF( 1592 KB)

Value of Multimodal Ultrasonography Combined with Clinical Indicators in Predicting the Progression of Ischemic Stroke

doi: 10.12259/j.issn.2095-610X.S20240325

1.
Dept. of Ultrasound Medical Imaging
2.
Dept. of Emergency Medicine，The 3rd People’s Hospital of Yunnan Province，Kunming Yunnan 650011，China

Received Date: 2023-12-13
Publish Date: 2024-03-25

Abstract

Abstract

Objective To investigate the clinical value of multimodal ultrasonography combined with clinical indicators in predicting the progression of ischemic stroke （IS）. Methods A total of 134 patients with IS admitted to Third People's Hospital of Yunnan Province from January 2020 to October 2022 were selected as study objects and were divided into progressive ischemic stroke （PIS） group （n=20） and non-progressive ischemic stroke （NPIS） group （n=114） according to the National Institutes of Health Stroke Scale （NIHSS） score. The clinical indicators, multi-modal ultrasonic image manifestations and related parameters of the two groups were counted, the influencing factors of PIS were screened by Logistics, the nomogram model was drawn, and the predictive efficiency of the nomogram model was evaluated by ROC curve and calibration curve. Results There were significant differences in age, baseline nutritional risk index （GNRI） score, baseline homocysteine （Hcy） and baseline uric acid （UA） between the two groups （P < 0.05）. The peak time （TTP）, peak intensity （PI）, the area under the curve （AUC）, carotid plaque enhancement mode, the mean value of maximum elastic modulus （MEmax） and mean value of minimum elastic modulus （MEmin） were compared between the two groups, and the differences were statistically significant （ P < 0.05）. Logistic analysis showed that baseline GNRI score, baseline UA, TTP, PI, AUCTC, carotid plaque enhancement pattern, MEmax and MEmin were the influencing factors of PIS （ P< 0.05）. Based on the above factors, the nomogram model was drawn. ROC curve and calibration curve showed that the model had good prediction efficiency, and the prediction efficiency was in good agreement with the reality. Conclusion The influencing factors of PIS include baseline GNRI score, baseline UA, TTP, PI, AUCTC, carotid plaque enhancement pattern, MEmax, MEmin, and the neagram model based on the above factors has good differentiation and accuracy.
- Multimodal ultrasound image,
- Clinical index,
- Carotid artery plaque,
- Ischemic stroke,
- Neurological impairment,
- Quantitative parameter

FullText(HTML)

References(25)

References

[1]	Feske S K. Ischemic stroke[J]. Am J Med,2021,134(12):1457-1464. doi: 10.1016/j.amjmed.2021.07.027
[2]	DeLong J H,Ohashi S N,O'Connor K C,et al. Inflammatory responses after ischemic stroke[J]. Semin Immunopathol,2022,44(5):625-648. doi: 10.1007/s00281-022-00943-7
[3]	Zhao T,Zhu T,Xie L,et al. Neural stem cells therapy for ischemic stroke: Progress and challenges[J]. Transl Stroke Res,2022,13(5):665-675. doi: 10.1007/s12975-022-00984-y
[4]	Yang D B,Zhou J,Feng L,et al. Value of superb micro-vascular imaging in predicting ischemic stroke in patients with carotid atherosclerotic plaques[J]. World J Clin Cases,2019,7(7):839-848. doi: 10.12998/wjcc.v7.i7.839
[5]	Rabelo N N,Telles J P M,Pipek L Z,et al. Homocysteine is associated with higher risks of ischemic stroke: A systematic review and meta-analysis[J]. PLoS One,2022,17(10):e0276087. doi: 10.1371/journal.pone.0276087
[6]	王娅,周厚援,罗志强,等. 新预测模型AULTS评分对缺血性脑卒中的预测价值[J]. 中华全科医学,2021,19(10):1666-1668,1696.
[7]	中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志,2018,51(9):666-682. doi: 10.3760/cma.j.issn.1006-7876.2018.09.004
[8]	张秀玲. 实时超声弹性成像技术评估脑卒中患者颈动脉斑块稳定性的应用研究[J]. 广州医药,2020,51(1):14-18. doi: 10.3969/j.issn.1000-8535.2020.01.004
[9]	乐元洁,陈慧敏,贲志飞. 颈动脉斑块患者超声造影评级与脑卒中危险因素的相关性分析[J]. 现代实用医学,2017,29(4):438-439. doi: 10.3969/j.issn.1671-0800.2017.04.011
[10]	Martinez-Sanchez P,Alexandrov A V. Ultrasonography of carotid plaque for the prevention of stroke[J]. Expert Rev Cardiovasc Therm,2013,11(10):1425-40. doi: 10.1586/14779072.2013.816475
[11]	陈欣,马赟英,尹少华,等. 进展性缺血性脑卒中患者血糖、C-反应蛋白变化特点及与预后的相关性[J]. 河北医药,2021,43(17):2589-2593. doi: 10.3969/j.issn.1002-7386.2021.17.006
[12]	吴方玲,胡金花,黄菊霞,等. 颈动脉斑块超微血流成像联合颈动脉彩色多普勒血流成像血流动力学参数对进展性缺血性脑卒中的预测价值[J]. 中国医药导报,2023,20(8):91-94.
[13]	Yan D,Shen Z,Zhang S,et al. Prognostic values of geriatric nutritional risk index (GNRI) and prognostic nutritional index (PNI) in elderly patients with diffuse large b-Cell lymphoma[J]. J Cancer,2021,12(23):7010-7017. doi: 10.7150/jca.62340
[14]	姜逍瑶,赵旭东,鲍磊,等. 老年营养风险指数对急性缺血性脑卒中患者预后的预测价值[J]. 中华老年心脑血管病杂志,2023,25(1):35-38. doi: 10.3969/j.issn.1009-0126.2023.01.010
[15]	Esse R,Barroso M,Tavares de Almeida I,et al. The contribution of homocysteine metabolism disruption to endothelial dysfunction: State-of-the-art[J]. Int J Mol Sci,2019,20(4):867. doi: 10.3390/ijms20040867
[16]	Gherghina M E,Peride I,Tiglis M,et al. Uric acid and oxidative stress-relationship with cardiovascular,metabolic,and renal impairment[J]. Int J Mol Sci,2022,23(6):3188. doi: 10.3390/ijms23063188
[17]	张力维,谌雪,王义成,等. 颈动脉斑块SMI分级联合血清同型半胱氨酸对进展性缺血性脑卒中的预测价值[J]. 中国超声医学杂志,2022,38(2):125-128. doi: 10.3969/j.issn.1002-0101.2022.02.002
[18]	周媛,杨小迪. 血尿酸和脑钠肽水平与进展性缺血性脑卒中的相关性研究[J]. 蚌埠医学院学报,2016,41(9):1152-1154.
[19]	Xu M,Jin S,Li F,et al. The diagnostic value of radial and carotid intima thickness measured by high-resolution ultrasound for ischemic stroke[J]. J Am Soc Echocardiogr,2021,34(1):72-82. doi: 10.1016/j.echo.2020.09.006
[20]	Hoyer U C I,Lennartz S,Abdullayev N,et al. Imaging of the extracranial internal carotid artery in acute ischemic stroke: assessment of stenosis,plaques,and image quality using relaxation-enhanced angiography without contrast and triggering (REACT)[J]. Quant Imaging Med Surg,2022,12(7):3640-3654. doi: 10.21037/qims-21-1122
[21]	李朝军,金琳,王枫,等. 应用剪切波弹性成像评价急性缺血性脑卒中患者颈动脉弹性及其相关因素[J]. 中华超声影像学杂志,2015,24(7):571-575. doi: 10.3760/cma.j.issn.1004-4477.2015.07.005
[22]	顾秀娟,张巍,郑帅,等. 颈动脉斑块常规超声及超声造影预测颈动脉狭窄患者缺血性脑卒中[J]. 中国介入影像与治疗学,2022,19(9):570-574.
[23]	孙飞一,潘晓芳,贾晓东,等. 多模态超声检查结合临床预测颈动脉粥样硬化患者缺血性脑卒中或短暂性脑缺血复发[J]. 中国医学影像技术,2022,38(1):53-58.
[24]	Dabravolski S A,Markin A M,Andreeva E R,et al. Molecular mechanisms underlying pathological and therapeutic roles of pericytes in atherosclerosis[J]. Int J Mol Sci,2022,23(19):11663. doi: 10.3390/ijms231911663
[25]	Yao J,Yang Z,Huang L,et al. Low-intensity focused ultrasound-responsive ferrite-encapsulated nanoparticles for atherosclerotic plaque neovascularization theranostics[J]. Adv Sci (Weinh),2021,8(19):e2100850. doi: 10.1002/advs.202100850

Relative Articles(20)

Relative Articles

[1]	Jiajia XUE, Xiaoxiao WANG, Xu WANG, Yuanyuan SUN, Honglu ZHU. Application of Thyroid Function Indicators Combined with Transcranial Doppler Ultrasound and Carotid Ultrasound in the Assessment of Vascular Stenosis in Atherosclerotic Cerebral Infarction. Journal of Kunming Medical University, 2024, 46(): 1-7.
[2]	Yunfang ZHANG, Shanshan ZHUANG, Yan YU, Zheng LI, Xiaoming WU, Xiaogai NIE. Correlation between PEAR1 Gene Polymorphisms and Ischemic Stroke. Journal of Kunming Medical University, 2023, 44(11): 135-139. doi: 10.12259/j.issn.2095-610X.S20231120
[3]	Chengcai ZHANG, Rong NING, Na CHEN, Yichen PENG, Li ZHOU, xichen YANG, Jingyi LU, Pengyue ZHANG, Rui LI. Effect of Median Nerve Electrical Stimulation on Synaptic Plasticity in Ischemic Stroke Rats. Journal of Kunming Medical University, 2023, 44(12): 6-12. doi: 10.12259/j.issn.2095-610X.S20231201
[4]	Wandong YANG, Yongfeng LI, Chunhua XIAO, Huimin PU, Hong LI, Wei YANG, Yan SHEN, Shilan DING, Chengcheng ZHU, Xiangfeng MIN. Clinical Application of Multimodal Ultrasound in Monitoring DBD Renal Transplantation. Journal of Kunming Medical University, 2022, 43(3): 113-122. doi: 10.12259/j.issn.2095-610X.S20220321
[5]	Rong ZHANG, Xingju SONG, Lin Duan, Qian LI, Xu CHEN. Effect of Butylphthalide on NIHSS and Hemorheology in Patients with Acute Cerebral Infarction. Journal of Kunming Medical University, 2022, 43(8): 66-71. doi: 10.12259/j.issn.2095-610X.S20220810
[6]	Zhi-peng YU, Ai-ran DONG, Jing ZHANG, Fang WU, Ming-jie GAO, Jian CHEN, Hong CHANG, Li-yong WU. Clinical Characteristics of Acute Ischemic Stroke Based on Multiple Imaging Evaluation. Journal of Kunming Medical University, 2021, 42(10): 51-60. doi: 10.12259/j.issn.2095-610X.S20211039
[7]	Ma Run , Chen Xiao Hong , Shen Xiu Fen , Tao Shu . . Journal of Kunming Medical University, 2020, 41(08): 88-93.
[8]	Liu Hong Wei , Yao Jian Hui , Liu Peng Jun , Li Wei Min . . Journal of Kunming Medical University, 2020, 41(04): 18-24.
[9]	Li Ling , Zhang Fang , He Xiao Feng , Hu Jian Rong , Wu Qiong . . Journal of Kunming Medical University, 2019, 40(11): 165-170.
[10]	Liu Xin Zhi , Zhao Heng , Luo Yi , Xu Min Hua , Min Xiao Li . . Journal of Kunming Medical University, 2018, 39(10): 121-125.
[11]	Li Ke Xing , Zou Yi , Zhang Li Jiao . Effect of Gangliosides in Improving the Cerebral Blood Flow and Nerve Function Indexes of Newborns with Hypoxic Ischemic Encephalopathy. Journal of Kunming Medical University, 2017, 38(04): 113-116.
[12]	Yuan Bin . Roles of Percutaneous Coronary Intervention in Improving Left Ventricular Function， Reducing Incidence of Cardiovascular Events of Patients With Ischemic Cardiomyopathy. Journal of Kunming Medical University,
[13]	Ren Chao Feng . . Journal of Kunming Medical University,
[14]	Liang Juan . . Journal of Kunming Medical University,
[15]	Lu Zheng . . Journal of Kunming Medical University,
[16]	Zhang Tao . . Journal of Kunming Medical University,
[17]	Wang Zhi Min . . Journal of Kunming Medical University,
[18]	Gao Hong . . Journal of Kunming Medical University,
[19]	. Clinical Analysis of 113 Caes of Upper Gastrointestinal Bleeding with Ischemic Myocardial Injury. Journal of Kunming Medical University,
[20]	Zhu Xing Bao . . Journal of Kunming Medical University,