Objective To investigate the distribution characteristics and clinical application value of Gray-Weale (GW) classification of symptomatic carotid plaque.

Methods Sixty inpatients with carotid artery bifurcation atherosclerosis (AS) plaques undergoing carotid doppler ultrasonography were randomly selected. Patients were divided into symptomatic group (n=32) and asymptomatic group (n=28) according to whether they had experienced an ischemic cerebrovascular event within 6 months. The GW classification of patients'plaques was analyzed. Carotid artery bifurcation plaque thickness, plaque length and the number of plaque were evaluated by ultrasound.

Results A total of 60 carotid bifurcation plaques were analyzed by GW classification, 32 plaques in symptom group, including 6 with typeⅠ, 17 with type Ⅱ, 7 with type Ⅲ, and 2 with type Ⅴ; there were 28 plaques in asymptomatic group, including 2 plaques in type Ⅰ, 7 plaques in type Ⅱ, 17 plaques in type Ⅲ, 2 plaques in type Ⅳ. There was statistically significant difference between the two groups in GW classification (P < 0.05). The plaque thickness in the symptomatic group was significantly higher than that in the asymptomatic group (P < 0.05). There was a negative correlation between plaque GW classification and plaque thickness (r=-0.53, P < 0.01). Cohen's Kappa consistency test results showed that Cohen's Kappa coefficient was 0.874 (95%CI, 0.766 2 to 0.981 8, P < 0.001).

Conclusion GW plaque classification has good stability and repeatability in evaluating echo characteristics of carotid atherosclerotic plaques. Plaque GW classification can be used as an effective method to screen symptomatic carotid plaque.