斑块内新生血管分布特征的超声造影与病理对照  

Distribution characteristics of neovascularization in carotid artery plaque of CEUS:Compared with histopathology

作　　者：宁彬[1] 何文[1] 张东[1] 张秀茹[1] 张红霞[1] 李铄[1] 田凤兰[1] 

机构地区：[1]首都医科大学附属北京天坛医院超声科,北京100050

出　　处：《中国医学影像技术》2015年第5期655-658,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨症状性颈动脉内膜剥脱术(CEA)患者颈动脉杈斑块内新生血管分布情况,并与病理对照分析。方法对27例拟行CEA(CEA组)患者和25例无症状性颈动脉斑块形成患者(对照组)行CEUS检查。观察两组斑块增强分布特征。对CEA患者术后标本行组织病理检查。结果 CEA组3例无增强;24例增强,其中20例(20/24,83.33%)基底部、中部及近内膜均增强,4例(4/24,16.67%)基底部和(或)中部增强,而内膜处无增强;对照组9例无增强,16例增强,其中4例(4/16,25.00%)基底、中部及近内膜处均增强,12例(12/16,75.00%)基底部和(或)中部增强,而近内膜处无增强,CEA组斑块近内膜处增强发生率(20/27,74.07%)明显高于对照组(4/16,25.00%;χ2=13.61,P<0.01);两组斑块基底部及中部增强率比较,差异无统计学意义(P>0.05)。病理结果显示CEA组斑块不同节段(近心段、中段及远心段)的基底部、中部、近内膜处均可见新生血管。结论颈动脉斑块CEUS可评价斑块内新生血管分布情况,近内膜处出现新生血管高度提示斑块不稳定。Objective To investigate distribution of neovascularization of carotid plaque in carotid endarterectomy （CEA） patients, and compared with the histopathology. Methods Twenty-seven cases of symptomatic carotid artery plaque （CEA group）, 25 cases of asymptomatic carotid artery plaque （control group） were underwent CEUS. The characteristics of enhancing distribution of plaque （endometrial, basilar, middle part） were observed. Postoperative histopathological ex- amination in CEA group were performed. Results In CEA group, 24 were enhanced, 20 cases （20/24, 83. 33%） of those plaques were enhanced in all of the three parts of the whole plaque, but 4 cases （4/24, 16.67%） were enhanced in only basilar part and （or） middle part~ in control group, 4 cases （4/16, 25.00~） were enhanced in all of the three parts, while 12 （12/16, 75.000%） were enhanced in basilar and （or） middle part. The incidence of endometrial enhancing in CEA group （20/27, 74. 07%） was statistically higher than that of in control groups （4/16, 25. 00% x2 = 13.61, P〈0. 01）, and there was no statistical significance enhancements of basilar part or middle part in both groups （all P〉0. 05）. Pathology showed all of the specimens in CEA group had new vessels which was distributed in different part of the plaque. Conelus｜on CEUS can evaluate the distribution of neovascularization of the plaques, the neovascularization under the endometriaI indicate the instability of plaque.

关 键 词：颈动脉 动脉粥样硬化 超声检查 造影剂 新生血管 组织病理学 

分 类 号：R543.4[医药卫生—心血管疾病]