Value of conventional ultrasound and contrast-enhanced ultra-sound in the diagnosis and follow-up of transient perivascular inflammation of the carotid artery syndrome

Mengke Zhang; Nan Li

摘要：Background Transient perivascular inflammation of the carotid artery(TIPIC)syndrome is relatively rare.Cur-rent research on conventional ultrasound and contrast-enhanced ultrasound(CEUS)for examining this condition is predominantly confined to case reports.Therefore,this study aimed to evaluate the value of conventional ultra-sound and CEUS in the diagnosis and follow-up of TIPIC syndrome. Methods The study conducted a retrospective analysis of 30 patients with TIPIC syndrome who were treated be-tween January 2016 and September 2025.We analyzed their conventional ultrasonographic and CEUS features and compared the evolution of these characteristics during follow-up visits(14 days,1 month,3 months,and 6 months). Results The mean(±standard deviation)maximum thickness of the lesions was 4.4±0.9 mm,and the mean involved length of the lesions was 24.2±8.1 mm.A Pearson correlation analysis showed that the maximum thick-ness of the lesions was positively correlated with lesion length at the initial visit,14-day follow-up,and 1-month follow-up(r=0.442,r=0.465,and r=0.802;P=0.014,P<0.001,and P<0.001,respectively).On conventional ultrasound,TIPIC lesions typically presented as unilateral(100%),eccentric(100%),with perivascular wall thick-ening of the common carotid artery or its bifurcation(100%),and appeared as hypoechoic areas without luminal stenosis(100%).On CEUS,these lesions were mainly diffuse(93.3%)and showed hyperenhancement(90%).During the follow-up,all patients showed a gradual reduction in the lesion thickness and involved area(both P<0.001),accompanied by significantly decreased CEUS enhancement intensity(P<0.001).Most lesions resolved completely within 3 months or earlier(93.3%). Conclusions Conventional ultrasound and CEUS can provide diagnostic imaging evidence for TIPIC syndrome.These techniques play a crucial role in the diagnosis,evaluation of treatment efficacy,and follow-up monitoring of this syndrome,and should be considered the first-line imaging modality.