颈动脉粥样硬化斑块成分的超声、磁共振影像学分析  

ULTRASOUND AND MRI ANALYSIS OF HUMAN CAROTID PLAQUE COMPOSITIONS

作　　者：王晓刚[1] 周定标[1] 李俊来[1] 许剑宏[1] 陈穗惠[1] 蔡健鸣[1] 

机构地区：[1]解放军总医院

出　　处：《解放军医学杂志》2002年第8期674-676,共3页Medical Journal of Chinese People's Liberation Army

基　　金："十五"国家科技攻关计划重大疾病防治研究项目资助课题 (编号2 0 0 1BA70 3B1 6)

摘　　要：为了探讨体内外颈动脉粥样硬化斑块的超声、MRI影像与斑块内病理成分的相关性 ,对颈动脉狭窄患者 2 0例 ,共 2 2侧血管的硬化斑块进行超声及MRI检查并记录影像。将影像与病理切片相匹配 ,分析斑块成分的超声及MRI影像学表现 ,并将各种病理成分的超声影像用 2 5 6级灰度值进行量化。结果表明 ,体内斑块中钙化、纤维组织、出血 /血栓、脂质的超声影像灰度值分别为 (89±12 ) ,(5 3±8) ,(37±6 )和 (39±3) ,体外斑块中钙化、纤维组织、出血 /血栓、脂质的超声影像灰度值分别为 (16 8± 11) ,(136± 12 ) ,(85± 12 )和 (89± 10 )。体内斑块中的钙化、纤维组织、陈旧出血 /血栓、脂质成分在MRIT1加权像上分别为低信号、等信号、等信号、极高信号 ,在质子像上分别为极低信号、等信号、高信号、高信号 ,在T2 加权像上分别为低信号、等信号或轻度高信号、高信号、高信号。体外斑块MRI检查结果与体内斑块检查结果相符合。说明灰度值分析可以对动脉硬化斑块中不同病理成分的超声影像进行量化处理 。To correlate the ultrasound and MR imaging of carotid atherosclerotic plaque with its histologic compositions,20 patients(22 lesions) scheduled for carotid endarterectomy were examined by B mode ultrasound and MRI preoperatively. The specimens were also examined postoperatively and the images of carotid plaque were recorded. The transverse pathological sections of plaques were made and matched with images of ultrasound and MRI. 256 gray scale ultrasound densitometric analysis of carotid plaque compositions was performed. Ultrasonic density of calcium, fibrous tissue, hemorrage/thrombus and lipid deposits was (89±12), (53±8), (37±6) and (39±3) respectively in vivo , and was (168±11), (136±12), (85±12) and (89±10) respectively in vitro . In vivo relative signal intensities of calcium, fibrous tissue, old hemorrhage/thrombus and lipid deposits were low, equal, equal and very high respectively on T 1 W MR image, and very low, equal, high and high respectively on PDW MR image, and low, equal or slightly high, high and high respectively on T 2 W MR image. Signal intensities of plaque contents ex vivo were correlated to signal intensities in vivo. Densitometric analysis of ultrasound images of carotid plaques can quantify possible components of plaque, and MRI has the feasibility to identify the components of plaque.

关 键 词：颈动脉粥样硬化斑块 动脉粥样硬化 颈动脉内膜切除术 超声检查 磁共振成像 

分 类 号：R653.04[医药卫生—外科学]