| 李海欣,阚艳敏,宁彬,余海歌,何文.颈动脉斑块超声造影增强特征与其病理特征及易损性的相关性[J].中国医学影像技术,2021,37(6):857~861 |
| 颈动脉斑块超声造影增强特征与其病理特征及易损性的相关性 |
| Correlations of contrast enhanced ultrasound manifestations, pathological features and vulnerability of carotid artery plaque |
| 投稿时间：2020-09-17 修订日期：2021-04-29 |
| DOI：10.13929/j.issn.1003-3289.2021.06.013 |
| 中文关键词: 颈动脉 斑块 超声造影 病理学 |
| 英文关键词:carotid arteries plaque contrast enhanced ultrasound pathology |
| 基金项目:首都卫生发展科研专项项目（首发2016-2-2045）。 |
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| 中文摘要: |
| 目的 采用超声造影（CEUS）评价颈动脉粥样硬化斑块增强特征与斑块中新生血管及弹性蛋白形态等病理特征及其易损性的相关性。方法 纳入124例颈动脉粥样硬化斑块患者，根据6个月内有无短暂性脑缺血发作（TIA）或非致死性脑卒中将其分为症状组（n=40）和非症状组（n=84），比较组间CEUS增强等级差异；其中60例接受颈动脉内膜剥脱术（CEA）并获得病理学结果，评价CEUS增强等级与斑块内新生血管、弹性蛋白形态的相关性；以Ⅱ级增强为标准判断斑块易损性，并与病理结果对照，评价CEUS判断斑块易损性的效能。结果 症状组颈动脉斑块CEUS增强等级高于非症状组（P<0.05）。斑块CEUS表现为0级增强时，其内弹性蛋白以波浪状为主；Ⅱ级增强时，以平直或断裂状为主；不同增强等级斑块弹性蛋白形态差异具有统计学意义（P<0.05）。斑块CEUS增强等级与其微血管密度（MVD）呈正相关（r=0.62，P<0.01）。CEUS判断斑块易损性的敏感度、特异度、阳性预测值和阴性预测值分别为74.36%、61.91%、78.00%和57.00%。结论 症状性颈动脉斑块新生血管较多，其CEUS增强等级与新生血管数量及弹性蛋白形态有关；CEUS评价颈动脉粥样硬化斑块的效能较高。 |
| 英文摘要: |
| Objective To observe the correlations of contrast enhanced ultrasound (CEUS) manifestations, pathological features and the vulnerability of carotid artery plaque. Methods A total of 124 patients with carotid arteriosclerosis plaques were enrolled and divided into symptomatic group (n=40) and asymptomatic group (n=84) according to with or without occurrence of transient ischemic attack (TIA) or non-fatal stroke within 6 months. The CEUS enhancement grades were compared between groups. Among 124 patients, carotid endarterectomy (CEA) was performed in 60 cases and pathological results were obtained, and the correlations of CEUS enhancement grades and the morphology of neovascularization and elastin of the plaque were evaluated. Ⅱ grade enhancement was used as the standard to assess plaque vulnerability, and the efficacy of CEUS for judging plaque vulnerability was evaluated through comparing with pathological results. Results CEUS enhancement grades of carotid plaques in symptomatic group was higher than that in asymptomatic group (P<0.05). In plaques with CEUS grade 0, the elastin was mainly wavy, while in those with CEUS grade Ⅱ enhancement, the elastin was mainly flat or fractured. There were significant differences of elastin morphology among plaques with different enhancement grades (P<0.05). There was positive correlation of CEUS enhancement patterns and microvessel density (MVD) (r=0.62, P<0.01). The sensitivity, specificity, positive predictive value and negative predictive value of CEUS for plaque vulnerability determination was 74.36%, 61.91%, 78.00% and 57.00%, respectively. Conclusion Symptomatic carotid plaques had much neovascularization, and CEUS enhancement grades were related to the quantity of neovascularization and elastin morphology. The efficacy of CEUS in evaluating carotid atherosclerotic plaques was relatively high. |
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