Abstract: Objective To explore the evaluation value of superb micro-vascular imaging(SMI) for internal carotid artery occlusion(ICAO) and to analyse the risk factors of plaque neovascularization. 
Methods  A total of 120 young and middle-aged obese patients with diabetes who had homogeneous iso-echo or hypoechoic plaques in the carotid artery detected in the Department of Ultrasound Medicine of our hospital were selected and detected by SMI and Digital subtraction angiography(DSA) for ICAO. They were divided into neovascularization group(n=98) and non-neovascularization group(n=22) according to the results of SMI detection. The clinical data of patients in two groups were collected for univariate analysis, and risk factors for plaque neovascularization were analyzed using multivariate unconditioned Logistic regression analysis. 
Results The probability of ICAO among 120 patients detected by SMI and DSA was 13.33% and 18.33% respectively, and the test results were in good consistency(Kappa=0.814, P=0.023). Smoking history, history of coronary heart disease(CHD), history of cerebral infarction as well as increased serum low-density lipoprotein cholesterol(LDL-C) and C-reactive protein(CRP) levels were the independent risk factors for plaque neovascularization in young and middle-aged obese patients with diabetes(OR=1.047, 1.388, 2.319, 2.094, 1.951, P＜0.05 or P＜0.01). 
Conclusion SMI has a high diagnostic value for ICAO, which in good consistency with DSA examination results. Smoking history, history of CHD, history of cerebral infarction and increased serum LDL-C and CRP levels are the independent risk factors for plaque neovascularization in young and middle-aged obese patients with diabetes.

Key words: ultrasonography, carotid artery diseases, risk factors