超声造影QontraXt评价颈动脉斑块新生血管与缺血性脑卒中的关系  

Relations of carotid plaque neovascularization and ischemic stroke evaluated by CEUS QontraXt

作　　者：蔡秋琼[1] 陈明[2] 江怡[1] 王颖[1] 赵云歆[1] 康慧莉[1] 姚广力[1] 梅将军[1] CAI Qiu-qiong CHEN Ming JIANG Yi WANG Ying ZHAO Yun-xin KANG Hui-li YAO Guang-li MEI Jiang-jun(Department of Ultrasound, Pudong New Area, Shanghai Punan Hospital, Shanghai 200125, China Department of Ultrasound, Tongji University Affiliated East Hospital, Shanghai 200120, China)

机构地区：[1]上海市浦东新区浦南医院超声科,上海200125 [2]同济大学附属东方医院医学超声科,上海200120

出　　处：《中国临床医学影像杂志》2016年第11期770-773,共4页Journal of China Clinic Medical Imaging

基　　金：上海市浦东新区卫生系统优秀青年医学人才培养计划(No:PWRq2014-18)

摘　　要：目的:探讨超声造影Qontra Xt软件分析预测缺血性脑卒中的可行性,利用Qontra Xt软件分析颈动脉低回声斑块超声造影增强特点与缺血性脑卒中的关系。方法:我院2010年1月—2013年1月就诊发现颈动脉斑块患者中筛选出114例低回声斑块进行常规超声造影并采用Qontra Xt软件进行分析,对患者随访时间平均为(3.1±0.8)年,期间发生脑卒中患者54例作为脑卒中组,未发生缺血性卒中患者60例作为对照组,采用软件的TIC曲线及彩色增强图功能对斑块造影图像进行脱机分析。结果:超声造影分析发现脑卒中组斑块增强峰值强度(Peak)(34.04±4.82 vs 21.63±3.54)明显高于对照组(P=0.000)。斑块增强强度与动脉管腔内增强强度比值(P/L Ratio)(0.59±0.10 vs 0.46±0.18)脑卒中组显著大于对照组(P=0.000、0.000)。利用Qontra Xt软件获得的彩色增强图所预测的低回声斑块发生破裂引发缺血性脑卒中较常规超声造影敏感性及特异性更高,敏感性及特异性分别为(35.18%vs 77.78%,68.33%vs 90.00%)。结论:利用Qontra Xt软件对颈动脉斑块进行定量分析较常规超声造影能够更客观地评估斑块新生血管情况,有助于更准确地预测发生缺血性卒中的风险。Objective： To explore the feasibility of QontraXt software in carotid plaques by contrast-enhanced ultrasound（CEUS） on predicting ischemic stroke, and to analyze the relation between ischemic stroke and the characteristics of hypoechoic carotid plaque. Methods： Totally 114 patients with hypoechoic carotid plaque were filtrated from January 2010 to January 2013 in our hospital. The regular CEUS were performed and the data were analyzed by QontraXt software. The patients were followed-up for 3.1±0.8 years. Fifty-four patients with stroke were defined as the stroke group. Meanwhile, sixty patients without stroke were defined as the control group. The TIC curve and color enhanced image in the software were analyzed off-line. Results： Compared with the control group, the enhanced peak were significantly higher in the stroke group（34.04±4.82 vs 21.63±3.54; P=0.000）. Plaques/arterial lumen enhanced intensity ratios（0.59±0.10 vs 0.46±0.18; P=0.000） in the stroke group were significantly larger. The sensitivity and specificity of enhancement figure prediction of ischemic stroke performed by QontraXt software was higher than the CEUS（35.18% vs 77.78%; 68.33% vs 90.00%）. Conclusions： The quantitative analysis of carotid plaques by QontraXt software based on CEUS may help to predict the risk of ischemic stroke more precisely through the evaluation of plaque neovascularization.

关 键 词：颈动脉 脑血管意外 超声检查 多普勒 彩色 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R543.5[医药卫生—临床医学]