超声造影综合评估颈动脉粥样斑块与脑梗死的关系  

Correlation between carotid atheromatous plaque and cerebral infarction assessed by contrast-enhanced ultrasound

作　　者：袁丽[1] 李秀兰[1] 肖艳[1] 丁波[1] 孙文兵[1] 吕静[1] 

机构地区：[1]江汉油田总医院超声科,湖北潜江433124

出　　处：《西南国防医药》2016年第5期475-477,共3页Medical Journal of National Defending Forces in Southwest China

基　　金：湖北省卫生厅科研基金指导性项目(JX3C60)

摘　　要：目的采用超声造影技术评价颈动脉粥样斑块的稳定性,并分析其与脑梗死的相关性及其预测价值。方法选取在我院经颈动脉普通超声检查确诊有颈动脉病变的患者142例,其中脑梗死患者49例,非脑梗死患者93例,采用超声造影检测并比较两组颈动脉分叉处粥样斑块相关指标,包括颈动脉狭窄、斑块厚度、造影剂到达时间差(DAT)、造影剂达峰时间差(DTTP)、增强强度(EI)和增强密度(DE)等。结果脑梗死组颈动脉粥样斑块DAT和DTTP较非梗死组缩短,EI和DE高于非脑梗死组;随着斑块增强级别的上升,脑梗死的发病率逐渐升高(P<0.05);斑块EI值逐渐上升,DTTP值逐渐缩短(P<0.05);Ⅰ、Ⅱ、Ⅲ级别斑块的DAT逐渐缩短(P<0.05),而Ⅳ级斑块的DAT突然延长,高于Ⅲ级别组斑块(P<0.05)。结论颈动脉粥样斑块超声造影检测指标能预测斑块稳定性及脑梗死发生,斑块造影的EI逐渐上升及DAT突然延长现象预示脑梗死发生的高风险。Objective To evaluate the stability of carotid atheromatous plaque by contrast-enhanced ultrasound, and to analyze the correlation between the carotid atheromatous plaque and cerebral infarction and the predictive value. Methods 142 patients with carotid artery diseases diagnosed by common ultrasound examination were selected. There were 49 cases of cerebral infarction and 93 cases of non-cerebral infarction. Contrast-enhanced ultrasound（CEUS） was used to detect and compare the characteristics of carotid artery atherosclerotic plaque in the two groups of patients, including the carotid artery stenosis, plaque thickness, contrast agent deviation of arrived time（DAT）, contrast agent deviation of time to peak（DTTP）, enhanced intensity（EI）, and enhanced density（DE）,etc. Results Compared with the indexes of non-cerebral infarction group, the DAT and DTTP in the cerebral infarction group were shorter, and the EI and DE were higher. Along with the increase of plaque enhancement level, the incidence of cerebral infarction increased（P 0.05）; the EI value increased, while the DTTP was shortened（P 0.05）; the DAT of grade Ⅰ, Ⅱ, and Ⅲ plaques was shortened（P 0.05）; and the DAT of grade Ⅳ was suddenly prolonged and higher than that of grade Ⅲ（P 0.05）. Conclusion Carotid atheromatous plaque ultrasound imaging can predict the stability of the plaques and the occurrence of cerebral infarction. The gradual increase of EI and the sudden extension of DAT indicate the high risk of cerebral infarction.

关 键 词：超声造影 脑梗死 颈动脉 斑块 强度 

分 类 号：R743.33[医药卫生—神经病学与精神病学]