熊莉,邓又斌,毕小军,朱英,伍玉晗,赵策瑶,石珍,刘娅妮.超声造影颈动脉粥样硬化斑块显影程度与急性脑血管病的关系[J].中国医学影像技术,2008,24(10):1583~1585
超声造影颈动脉粥样硬化斑块显影程度与急性脑血管病的关系
Relation of enhancement of carotid atherosclerotic plaques during contrast-enhanced ultrasonography to the acute cerebrovascular disease
投稿时间:2008-04-24  修订日期:2008-06-26
DOI:
中文关键词:  超声检查  造影剂  颈动脉疾病  脑血管病
英文关键词:Utrasonograph  Contrast media  Carotid arteriesdiseases disease  Cerebrovascular disease
基金项目:
作者单位E-mail
熊莉 华中科技大学同济医学院附属同济医院超声影像科,湖北 武汉 430030  
邓又斌 华中科技大学同济医学院附属同济医院超声影像科,湖北 武汉 430030 youdeng@public.wh.hb.cn 
毕小军 华中科技大学同济医学院附属同济医院超声影像科,湖北 武汉 430030  
朱英 华中科技大学同济医学院附属同济医院超声影像科,湖北 武汉 430030  
伍玉晗 华中科技大学同济医学院附属同济医院超声影像科,湖北 武汉 430030  
赵策瑶 华中科技大学同济医学院附属同济医院超声影像科,湖北 武汉 430030  
石珍 华中科技大学同济医学院附属同济医院超声影像科,湖北 武汉 430030  
刘娅妮 华中科技大学同济医学院附属同济医院超声影像科,湖北 武汉 430030  
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中文摘要:
       目的 应用实时超声造影技术评价颈动脉粥样硬化斑块显影程度与急性脑血管病的关系。方法 使用SonoVue实时超声造影检查48例患者的颈动脉粥样硬化斑块,其中23例患急性脑血管病,25例无急性脑血管病,根据时间-强度曲线图分析得出粥样硬化斑块显影后峰值强度/显影前强度比值(Post-PI/Pre-I)、斑块显影后峰值强度/颈动脉管腔显影峰值强度比值(Post-PI/Post-PIC),并分析其预测患者发生急性脑血管病截断值以及敏感性、特异性。结果 23例急性脑血管病患者中21例显影、无显影2例。25例无急性脑血管病患者粥样硬化斑块显影15例、无显影10例。两组患者粥样硬化斑块显影后峰值强度(Post-PI) , 粥样硬化斑块显影后峰值强度与显影前强度比值(Post-PI/Pre-I)(0.78±0.04对0.90±0.03,P<0.05), 斑块显影后峰值强度与颈动脉管腔显影峰值强度比值(Post-PI/Post-PIC)(1.28±0.06 对1.46±0.21, P<0.05)均有显著性差异。以粥样硬化斑块显影后峰值强度与显影前强度比值(Post-PI/Pre-I)<0.82 为截断值预测患者发生急性脑血管病敏感性为76.9%,特异性为64.1%,以斑块显影后峰值强度与颈动脉管腔显影峰值强度比值(Post-PI/Post-PIC)<1.35预测患者发生急性脑血管病敏感性为84.6%,特异性为60.4%。结论 超声造影能实时观察颈动脉粥样硬化斑块内的显影情况,并与急性脑血管病发生有关联。
英文摘要:
      Objective To evaluate the relationship between enhancement of carotid atherosclerotic plaques and the acute cerebrovascular disease (ACD) by contrast-enhanced ultrasonography with SonoVue. Methods Forty-eight patients with carotid atherosclerotic plaques were examined with contrast-enhanced ultrasonography. Of these patiens, 23 suffered from ACD, 25 patients had no acute cerebrovascular disease. The post-enhancement peak intensity in the plaque (Post-PI), the ratio of post-enhancement peak intensity to pre-enhancement intensity in the plaque (Post-PI/Pre-I), the ratio of post-enhancement peak intensity to post-enhancement peak intensity in the carotid cavity (Post-PI/Post-PIC) were measured and calculated from the time-intensity curve. Receiver-operating characteristic curves were constructed to evaluate the accuracy of enhancement of atherosclerotic plaques in predicting acute cerebrovascular disease. Results Contrast ultrasonography showed enhancement of the carotid plaque in 21 of 23 patients with ACD, while the carotid plaques were enhanced only in 15 of 25 patients without ACD. There were significant difference between two groups in Post-PI , Post-PI/Pre-I (0.78±0.04 vs 0.90±0.03, P<0.05) and Post-PI/Post-PIC (1.28±0.06 vs 1.46±0.21, P<0.05). A cutoff value of Post-PI/Pre-I<0.82 as a predictor of ACD had a sensitivity and specificity of 76.9% and 64.1%, respectively. Similarly, a cutoff value of Post-PI/Post-PIC<1.35 showed sensitivity and specificity of 84.6% and 60.4%, respectively. Conclusion Contrast-enhanced ultrasonography provides a new way to observe the neovascularization of the carotid plques. The enhancement of the carotid plaquemay be related with the onset of ACD.
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