To discuss the correlation between contrast-enhanced ultrasound grading of carotid plaque combined with blood homocysteine (Hcy) and arteriosclerotic ischemic stroke.

From October 2013 to July 2014, 159 patients at the department of neurology in Ningbo No.2 Hospital, according to the clinical guideline (Chinese ischemic stroke diagnostic criteria and improved TOAST classification), were respectively distributed into two groups: group A with 72 subjects of atherosclerotic ischemic stroke and group B with 76 subjects of non-ischemic stroke. All patients underwent contrast-enhanced ultrasound of carotid plaque and blood Hcy level. Spearman and Pearson correlation analysis were used respectively to test the correlation between arteriosclerotic ischemic stroke and carotid plaques contrast-enhanced ultrasound grade as well as blood Hcy level.

(1) The difference of the atherosclerotic plaque thickness and the plaque type in conventional ultrasound wasn′t significant statistical between group A and B (F=0.865, 0.827, all P>0.05). But there was a significant difference in the contrast-enhanced ultrasound grade (Z=192.350, P<0.01). With the contrast-enhanced ultrasound grade ≥3 as the diagnostic criteria to predict the occurrence of arteriosclerotic ischemic stroke, its sensitivity and specificity were 94.44% and 94.74%, respectively. (2) The difference between two groups in blood Hcy level was statistically significant (t=152.383, P<0.01). The area under the ROC curve was 0.978. With blood Hcy ≥13.50 μmol/L as diagnostic criteria to predict the occurrence of arteriosclerotic ischemic stroke, its sensitivity and specificity were 97.21% and 90.80%, respectively. (3) With the contrast-enhanced ultrasound grade ≥3 or blood Hcy ≥13.50 μmol/L as diagnostic criteria to predict the occurrence of arteriosclerotic ischemic stroke, its sensitivity and specificity were 98.71%, and 96.45%, respectively. (4) There were high linear correlations between arteriosclerotic ischemic stroke and contrast-enhanced ultrasound grade as well as blood Hcy level (r=0.865, 0.827, all P<0.01).

Contrast-enhanced ultrasound grading of carotid plaque and blood Hcy level could be used as an important predictive indicator of arteriosclerotic ischemic stroke, and provided important information for clinical secondary prevention.