超声造影评价颈动脉斑块内新生血管的应用研究  

Value of Contrast-enhanced Ultrasound in Evaluation of Carotid Plaque Neovascularization

作　　者：蒋彦彦[1] 朱建平[1] 孙立[1] 

机构地区：[1]福州总医院超声诊断科,福州市350025

出　　处：《中国超声医学杂志》2016年第9期776-779,共4页Chinese Journal of Ultrasound in Medicine

基　　金：福建省科技计划重点项目(No.2012Y5008)

摘　　要：目的 评价超声造影成像在颈动脉斑块易损性中的应用价值。方法 颈动脉粥样硬化患者39例,共64个斑块,常规超声将颈动脉斑块回声分成四种类型,进行0-3个等级的斑块超声造影视觉评分,定量计算四类斑块的增强强度值和增强密度值,并分析造影参数之间的相关性。结果四类斑块中均质低回声与不均质低回声斑块的超声造影视觉评分多为2、3分，分别约占66．7％（14／21）、92．3％（12／13）；均质高回声与不均质高回声斑块的视觉评分多为1分，分别约占58．8％（10／17）、46．2％（16／30），各种分值的增强强度值从1分-2分-3分依次增高，不同分值的超声造影增强强度值间差异有统计学意义（F=7．8034，P〈0．001）。四类斑块的超声造影增强强度值（χ^2=29．025，P〈0.001）和增强密度值（χ^2=30．871，P〈O．001）之间的差异有统计学意义，并存在线性相关（r=0．9363，P=0．000O）。结论超声造影可以在常规超声判断斑块性质的基础上，无创检测斑块内新生血管，为斑块易损性的评估提供了一种新的方法。Objective To evaluate the application value of contrast-enhanced ultrasound imaging （CEUS） in carotid artery plaque vulnerability. Methods A total of 39 patients with carotid atherosclerosis were incorporated in this study, containing a sum up of 64 plaques. Conventional ultrasound was applied for the classification of carotid plaque echogenicity into four types, and then each plaque from the four types was evacuated by visual scoring of plaques under contrast-en- hanced ultrasound in 0--3 grades. Subsequently, quantitative calculation was conducted regarding enhanced intensity values and enhanced density values o{ the above four types of plaques, correlations among different contrast parameters were finally analyzed. Results In the four kinds of plaques, visual scores between homogeneous low echo and heterogeneous low echo plaques under contrast-enhanced ultrasound was 2 points and 3 points, accounting for 66.7% （14/21） and 92.3% （12/13）, respectively. In addition, visual scores of homogeneous and heterogeneous high echo plaques were mainly 1 point, accounting for 58.8% （10/17） and 46.2% （16/30）, respectively. The intensity values of all kinds of scores increased from 1 point to 2 points and 3 points, respectively. There was significant difference in the intensity values of contrast-enhanced ultrasonography with different values（F= 7. 803 4, P〈0. 001）. Furthermore, there were significant differences of the enhanced intensity values（χ^2= 29. 025, P〈0.001） and the enhanced density values （χ^2=30. 871 ,P〈0.001） among the four types of plaques, suggesting a linear correlation（r=0. 936 3 ,P〈0. 000 0）. Conclusions Contrast-enhanced ultrasound can establish a noninvasive detection of neovascularization in plaques based on the properties of conventional ultrasound, providing a new method for plaque vulnerability assessment.

关 键 词：超声造影 超声检查 动脉粥样硬化 颈动脉 新生血管 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.4[医药卫生—诊断学]