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Objective:To explore the histopathological features of ulcer plaque identified by carotid CT angiography (CTA), and to explore the relationship between ulcer plaque and ischemic stroke from the microscopic perspective.Methods:Clinical data of 124 patients with carotid artery stenosis underwent carotid endarterectomy in our hospital from September 2016 to September 2020 were collected. According to the CTA results of carotid arteries, these patients were divided into ulcer plaque group ( n=47) and non-ulcer plaque group ( n=77). The clinical data, and vulnerability index and histopathological differences of placque tissues between the two groups were compared. Results:The proportion of patients with cerebral infarction history in ulcer plaque group was significantly higher than that in non-ulcer plaque group ( P<0.05). As compared with the non-ulcer plaque group, the ulcer plaque group had significantly higher proportions of fibrous cap rupture, intra-plaque hemorrhage and large necrotic core of lipid ( P<0.05). The vulnerability index of ulcer plaque group and non-ulcer plaque group was 2.01±0.51 and 0.49±0.25, respectively, with significant difference ( t=19.300, P<0.001). Conclusion:The ulcer plaque identified by CTA is correlated with fibrous cap rupture, intra-plaque hemorrhage and large necrotic core of lipid; at the same time, ulcer plaque is unstable and these patients are trended to have ischemic stroke.
ABSTRACT
Objective To investigate the effect of radiotherapy on carotid plaque ulcer formation by using ultrasound imaging.Methods Totally 93 cases diagnosed with head and neck cancers which had complete carotid ultrasound data and other baseline data before and after radiotherapy (RT) were retrospectively enrolled.The total number of plaques,average intima-media thickness,maximum plaque area,total number of ulcer plaques,maximum ulcer plaque area and the maximum area of the ulcer pit were compared in RT side and non RT side before and after RT respectively.Results The average interval time was 6.1±1.9 years between twice RT.Before RT,there were no statistical differences between RT side and non-RT side in the total number of plaques,the average intima-media thickness,maximum plaque area,total number of ulcer plaques,maximum ulcer plaque area and maximum area of the ulcer pit.After RT,compared with those of non-RT side,there were more lesions of the total number of plaques,the thicker average intima-media thickness,the larger maximum plaque area,the more maximum number of ulcer plaques,the larger maximum ulcer plaque area and maximum area of the ulcer pit in RT side,which had statistical defference (all P＜0.05).Conclusion RT can lead to the formation and progression of carotid atherosclerotic plaque in patients with head and neck cancers,and the plaque has a vulnerability characteristics.