Microembolic signals (MES) of the carotid artery are associated with plaque destabilization and reoccurrence of stroke. Previous studies have focused primarily on the degree of carotid artery stenosis and plaque components, and the relationship between plaque length and microembolic sign has received little attention. We aimed to find the association between carotid plaque length (CPL) and the presence of MES. We conducted a retrospective observational cross-sectional study. A total of 84 acute anterior-circulation ischemic stroke/transient ischemic attack (TIA) patients with carotid artery atherosclerosis were classified into an MES-positive (MES+) group and MES-negative (MES−) group. We measured multiple parameters of carotid plaque size (length, thickness) in each patient and evaluated the relationship between different plaque parameters and occurrence of MES. We found that male, carotid artery stenosis (CAS), CPL, carotid plaque thickness (CPT), and intima-media thickness (IMT) of the carotid artery were each significantly different between two groups (all ). The multivariate analysis showed CPL (odds ratio (OR), 1.109; 95% CI, 1.044–1.177; ) to be independently associated with the presence of MES. The areas under the ROC curves (AUCs) for CPL for predicting MES were 0.777 (95% CI, 0.640–0.914; ). The cutoff value of CPL for predicting MES was 16.7 mm, with a sensitivity of 88.2% and a specificity of 77.6%. We found that CPL was a meaningful independent predictor of MES. Therefore, CPL may be useful for risk stratification of long and nonstenotic plaques in anterior circulation stroke.

中文翻译：

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斑块长度预测急性前循环卒中中微栓塞信号的发生率

颈动脉的微栓塞信号 (MES) 与斑块不稳定和中风复发有关。以往的研究主要集中在颈动脉狭窄程度和斑块成分上，斑块长度与微栓塞征象的关系鲜有关注。我们旨在找出颈动脉斑块长度 (CPL) 与 MES 存在之间的关联。我们进行了一项回顾性观察性横断面研究。共有 84 例急性前循环缺血性卒中/短暂性脑缺血发作 (TIA) 颈动脉粥样硬化患者被分为 MES 阳性 (MES+) 组和 MES 阴性 (MES-) 组。我们测量了颈动脉斑块大小的多个参数（长度、厚度）并评估不同斑块参数与 MES 发生之间的关系。我们发现男性，颈动脉狭窄（CAS）、CPL、颈动脉斑块厚度（CPT）和颈动脉内中膜厚度（IMT）在两组之间均存在显着差异（所有）。多变量分析显示 CPL（优势比 (OR)，1.109；95% CI，1.044–1.177；)与 MES 的存在独立相关。CPL 预测 MES 的 ROC 曲线下面积 (AUC) 为 0.777（95% CI，0.640–0.914；）。CPL 预测 MES 的临界值为 16.7 mm，敏感性为 88.2%，特异性为 77.6%。我们发现 CPL 是一个有意义的 MES 独立预测因子。因此，CPL 可用于前循环卒中长斑块和非狭窄斑块的风险分层。