Aim: Arterial wall elasticity including the circumferential and longitudinal modulus is a measure of sub-clinical cardiovascular disease; the circumferential modulus is increased in acute ischemic stroke (AIS). There are still no reports of non-invasive measurement of longitudinal elastic modulus of arterial wall and its prospect of clinical application. In this study, the longitudinal elastic modulus of the arterial wall was assessed using real-time shear wave elastography in patients with AIS. The technique’s feasibility and its related factors were studied initially. Materials and methods: In this study 179 patients with AIS and 168 age- and sex-matched controls were examined. The pulse wave velocity (PWV) of the bilateral carotid arteries was measured using radio frequency ultrasound technology. The 20 areas of superficial walls of bilateral carotid artery were analyzed by real-time shear wave elastography (SWE), and the average values of longitudinal average elastic modulus (MEmean), maximum elastic modulus (MEmax), minimum elastic modulus (MEmin), and elastic modulus standard deviation (MESD) were measured. Results: The PWV, MEmean, MEmax and MESD of the carotid artery in patients with AIS were greater than those in the control group. Age, systolic blood pressure, PWV, and low-density lipoprotein were positively related to MEmean and MEmax (r=0.221and r=0.248, r=0.174 and r=0.176, r=0.776 and r=0.716, r=0.173 and r=0.200, p<0.05) and were independent risk factors for MEmean and MEmax。ROC curves for detection of ischemic stroke as decided by PWV, MEmean and MEmax. The area under the curves were 0.55±0.03 (p≤0.05), 0.59±0.03 (p≤0.05) and 0.60±0.03 (p=0.023), respectively. The optimal PWV, MEmean and MEmax cutoff values for the detection of ischemic stroke were 9.66 m/s, 55.4 kPa and 65.4 kPa, with 69%, 73% and 73% sensitivity and 89%, 53% and 51% specificity, respectively. Conclusions: SWE could measure non-invasively the longitudinal elastic modulus of the arterial wall and evaluate the arterial stiffness. It was equivalent to the PWV which showed circular elastic modulus of arterial wall on evaluating AIS. Age, systolic blood pressure, pulse wave velocity, and low-density lipoprotein were independent risk factors for longitudinal elastic modulus. SWE may be effective in the assessment of arterial stiffness and offer a potential clinical benefit.

Inflammatory activity plays a central role in the development of carotid rupture-vulnerable atherosclerotic plaques, which is one of the major contributors to acute ischemic stroke. Our objective was to characterize carotid intraplaque neovascularizations (INP) using contrast-enhanced ultrasound (CEUS) and evaluate plaque burden through exploring the relationship between INP and cell count of peripheral leukocytes. Sixty-two patients with large artery atherosclerosis (LAA) were enrolled in this study. CEUS was performed to characterize the carotid artery plaques. The correlations between the CEUS imaging features of carotid plaques and leukocyte counts were investigated. The results showed that the characteristic parameters derived from CEUS, including peak of time-intensity curve (TIC-P), mean of time-intensity curve (TIC-M), peak (FC-P), sharpness (FC-S) and area under the curve (FC-AUC) compared with the control group, were all increased in the stroke group. TIC-P, TIC-M and FC-P were negatively related to lymphocytes, respectively. FC-S and FC-AUC were positively correlated with neutrophils, respectively. Our study indicated carotid INP was closely related to the peripheral leukocytes count. CEUS may serve as a useful tool to predict vulnerability of plaque.

Background: Arterial remodeling is thought to reflect the adaptation of the vessel wall to mechanical and hemodynamic stimuli and contributes to the progression of cardiovascular and cerebrovascular diseases. Tensile stress (TS) is one of the mechanical properties of the artery wall. The purpose of this study was to investigate the tensile stress change (TS) of carotid artery with varying viscoelasticity in healthy subjects within two groups of different ages.Methods: Forty-five subjects were recruited and randomly assigned into the group at the age above 50 years and below 50 years. The carotid arteries were examined by ultrasonography, using the techniques of shear wave elastography (SWE), shear wave dispersion (SWD) and radiofrequency (RF) -based ultrasound. The following values, including elastic modulus (SWER) and viscous index (SWDR), as well as the peak and mean TS of the left and right carotid arteries (L-PTS, R-PTS, L-MTS and R-MTS) were measured. The correlations between SWER, SWDR and tensile stress were evaluated.Results: The SWE_Rand SWD_Rof carotid arteries are lower in the subjects ≥50 years old than the subjects younger than 50 years (SWE_R, 10.29 ± 9.57 kPa VS 17.24 ± 14.07 kPa; SWD_R,11.99 ± 3.51 (m/s)/kHz VS 13.97 ± 3.71 (m/s)/kHz,P < 0.05). The R-PTS was lower in the group with younger age (P < 0.05). Pearson correlation analysis showed that SWE_Rof carotid artery was positively correlated with the parameters of tensile stress, R-PTS, R-MTS, L-PTS and L-MTS(r = 0.218,r = 0.359,r = 0.209 andr = 0.369, respectively,P < 0.05). However, SWD_Rof carotid arteries was not significantly associated with TS.Conclusion: Ultrasonic shear wave imaging could be used to quantitatively assess carotid viscoelasticity. The carotid TS was related to its elasticity while little related to its viscosity, suggesting that mechanical properties of the arterial wall might be better revealed.Trial registration: Date of our trial registration: 2018-06-11. Registered with the official website of China Clinical Trial Registration Center (ChiCTR1800016590)

Aims: This study’s aim is to present the specific ultrasonography (US) findings of a series of urachus anomalies. Material and methods: Seven patients with suspected urachal anomalies underwent US scanning initially prior to the surgery and the features of images were reviewed respectively. The clinical data and pathologic results were collected also. Results: US successfully diagnosed urachal anomalies in 5 patients (5/7, 71.4%) and failed to diagnose in 2 patients (2/7, 28.6%). Patent urachus showed a tubule between the umbilicus and bladder; urachal sinus was a blind focal dilatation at the umbilical end, while vesicourachal diverticulum was an outpouching at the vesical end and urachal cyst was identified as an anechoic structure along the urachus. Non-enhancement in the base and centre was the distinct features of urachus carcinoma by contrastenhanced ultrasonography (CEUS). Using a high frequency probe and CEUS the diagnostic ability of US may be improved. Conclusion: US showed good diagnostic ability in urachal anomalies and combined with CEUS could improve the differential diagnosis.