超声造影评估腔隙性脑梗死患者颈动脉斑块的新生血管特点  

The characteristics of neovascularization of carotid plaque by contrast enhanced ultrasonograpy in patients with lacunar infarction

作　　者：宋则周[1] 张艳明[1] 傅燕飞 耿昱[3] 张帆[1] 汤靖岚[1] 王静[1] 

机构地区：[1]浙江省人民医院超声科,浙江杭州310014 [2]浙江省杭州市滨江区西兴街道社区卫生服务中心,浙江杭州310014 [3]浙江省人民医院神经内科,浙江杭州310014

出　　处：《医学影像学杂志》2015年第10期1731-1734,1738,共5页Journal of Medical Imaging

摘　　要：目的应用超声造影评估腔隙性脑梗死患者颈动脉斑块新生血管特点及其临床意义。方法对38例腔隙性脑梗死、41例非腔隙性脑梗死和20例非脑梗死患者的双侧颈动脉斑块行超声造影检查,参考文献对颈动脉斑块新生血管特点进行分级,分析并比较三组患者颈动脉斑块新生血管分级的特点,应用ROC曲线计算斑块分级评价腔隙性脑梗死、非腔隙性脑梗死及脑梗死的敏感性和特异性。结果腔隙性脑梗死和非腔隙性脑梗死的脑梗死侧斑块大多为Ⅲ级和Ⅳ级斑块,其他部位斑块大多为Ⅰ级和Ⅱ级,腔隙性脑梗死和非腔隙性脑梗死的脑梗死侧斑块分级明显大于其他部位斑块,腔隙性脑梗死和非腔隙性脑梗死的脑梗死侧斑块分级差异无统计学意义;入选人群中Ⅲ级和Ⅳ级斑块分级的患者中脑梗死的比例明显高于I级和Ⅱ级斑块分级的患者,非脑梗死和腔隙性脑梗死患者中Ⅲ级斑块分级的患者中腔隙性脑梗死的比例明显高于I级和Ⅱ级斑块分级的患者,非脑梗死和非腔隙性脑梗死患者中Ⅲ级和Ⅳ级斑块分级的患者中非腔隙性脑梗死的比例明显高于I级和Ⅱ级斑块分级的患者;以斑块分级>II级为标准评价腔隙性脑梗死、非腔隙性脑梗死和脑梗死的敏感性和特异性分别为63.9%,75.0%,67.2%,76.4%,65.4%,76.1%。结论腔隙性脑梗死患者的颈动脉斑块分级与非腔隙性脑梗死患者类似,其可能是造成二者长期预后相近的病理生理机制;颈动脉斑块超声造影分级是评价腔隙性脑梗死和非腔隙性脑梗死的有效参数。Objective To evaluate the characteristics of neovascularization of carotid plaque by contrast enhanced ultrasonograpy in patients with lacunar infarction and their clinical significance. Methods The bilateral carotid plaques in 38 patients with lacunar infarction, 41 patients with non-lacunar infarction and 20 patients with non-infarction, were studied by contrast enhanced ultrasonograpy. The grade of carotid plaque was assessed according to the relevant literature. The differences of grade of carotid plaque in the above-mentioned three kinds of patients were compared~ The sensitivity and specificity to evaluate lacunar infarction, non- lacunar infarction and infarction were calculated by ROC curve. Results The grade of carotid plaque was always grade III and IV at infarction side in patients with lacunar infarction and non lacu- nar infarction, the grade of carotid plaque was always grade I and II at the rest, and the grade of carotid plaque at infarc- tion side in patients with lacunar infarction and non- lacunar infarction was significantly higher than the rest. There are no differences in the grade of carotid plaque between patients with lacunar infarction and patients with nonqacunar infarction. The ratio of infarction in patients with grade III and IV plaque was significantly bigger than in patients with grade I and II plaque according to all the recruited patients, the ratio of infarction in patients with grade llI plaque was significantly big- ger than in patients with grade I and II plaque according to non-infarction and lacunar infarction patients, the ratio of in farction in patients with grade III and IV plaque was significantly bigger than in patients with grade I and II plaque according to non-infarction and lacunar infarction patients. The sensitivity and specificity to anticipate lacunar infarction, non-lacunar infarction and infarction were 63.9%, 75.0%, 67.2%, 76.4%, 65.4%, 76.1% respectively. Conclusion The grade of carotid plaque in patients with lacunar infarction is similar to that in patien

关 键 词：超声检查 造影剂 形态学 颈动脉 动脉硬化 

分 类 号：R445.1[医药卫生—影像医学与核医学] R743[医药卫生—诊断学]