This study aimed to examine the clinical and multimodal ultrasonic characteristics differences between carotid web (CW) and CW with plaque as well as the potential risk factors for stroke caused by CW. We retrospectively enrolled patients diagnosed with CW by CTA or high-resolution MRI (HRMRI) and simultaneously underwent contrast enhanced ultrasound (CEUS) and superb microvascular imaging examinations from January 2015 to October 2022. The CW angle was measured using computer-aided software. The variations between CW and CW with plaque were evaluated, and univariable and multivariable logistic regressions were utilized to identify possible risk predictors for stroke caused by CW. Two hundred ninety-nine patients with an average age of 60.85 (± 8.77) years were included. Sex, age, history of smoking, alcohol, hypertension, diabetes mellitus, homocysteine level, and treatment, as well as web length and thickness, luminal stenosis, location wall, number, CW angle, and CEUS enhancement, were quite different among CW and CW with plaque patients (p < 0.05). The logistic regression analysis showed that web length was an independent predictor of luminal stenosis in CW patients. For patients with CW and plaque, plaque and web thickness, as well as plaque enhancement, were associated with stenosis. Furthermore, luminal stenosis and plaque length were risk factors for symptoms. The multimodal ultrasonic and clinical manifestations of CW and CW with plaque are quite different. Web length is an independent risk factor for carotid artery stenosis in CW patients, whereas luminal stenosis and plaque length were risk factors for symptoms in CW with plaque patients. Exploring the similarities and differences between the carotid web and the carotid web with plaque, based on the stereo-geometric spatial position relationship and hemodynamic changes, may provide further insights into the underlying mechanisms of stroke occurrence caused by the carotid web. 1. Multimodal ultrasonic and clinical manifestations of carotid web and carotid web with plaque are substantially different. 2. A thin triangular endoluminal defect is identified as a typical feature of the web on superb microvascular imaging, and two kinds of typical ultrasonic features of CW with plaque are also identified. 3. Web length is an independent risk factor for carotid stenosis in carotid web patients, whereas luminal stenosis and plaque length are risk factors for symptoms in patients with CW and plaque.

中文翻译：

---

颈动脉网与有斑块的颈动脉网的区别：基于多模态超声和临床特征

本研究旨在探讨颈动脉蹼（CW）和有斑块的 CW 之间的临床和多模态超声特征差异，以及 CW 引起卒中的潜在危险因素。我们回顾性入组2015年1月至2022年10月期间经CTA或高分辨率MRI（HRMRI）诊断为CW的患者，并同时接受超声造影（CEUS）和卓越的微血管成像检查。使用计算机辅助软件测量CW角度。评估了 CW 和有斑块的 CW 之间的差异，并利用单变量和多变量逻辑回归来确定 CW 引起的中风的可能风险预测因子。共纳入 299 名患者，平均年龄为 60.85（±8.77）岁。CW和CW之间的性别、年龄、吸烟史、饮酒史、高血压、糖尿病、同型半胱氨酸水平、治疗以及网长度和厚度、管腔狭窄、位置壁、数量、CW角度和CEUS增强有很大差异。患有斑块的 CW 患者 (p < 0.05)。逻辑回归分析表明，网长度是 CW 患者管腔狭窄的独立预测因子。对于患有 CW 和斑块的患者，斑块和网厚度以及斑块增强与狭窄相关。此外，管腔狭窄和斑块长度是症状的危险因素。CW与有斑块的CW的多模态超声及临床表现有较大不同。网长度是 CW 患者颈动脉狭窄的独立危险因素，而管腔​​狭窄和斑块长度是 CW 斑块患者症状的危险因素。基于立体几何空间位置关系和血流动力学变化，探讨颈动脉网与斑块颈动脉网的异同，可以进一步深入了解颈动脉网引起脑卒中的潜在机制。1.颈动脉蹼和有斑块的颈动脉蹼的多模态超声和临床表现有本质区别。2.在优良的微血管成像上，将薄的三角形腔内缺损确定为网的典型特征，并且还确定了带有斑块的CW的两种典型超声特征。3.颈动脉网长度是颈动脉网患者颈动脉狭窄的独立危险因素，而管腔​​狭窄和斑块长度是CW和斑块患者出现症状的危险因素。