超声造影评价股动脉斑块新生血管与脑梗死的相关性  

Correlation Between Neovascularization in Femoral Artery Plaque and Cerebral Infarction Detected by Contrast Enhanced Ultrasound

作　　者：刘璐[1] 赵萍[2] 陈慧贞[2] 伍凌鹄 刘鸽[2] 

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]广州中医药大学第一附属医院超声科,广东广州510405 [3]深圳市人民医院超声科,广东深圳518020

出　　处：《中国医学影像学杂志》2017年第4期287-290,294,共5页Chinese Journal of Medical Imaging

基　　金：广东省省级科技计划项目(2016A020215140)

摘　　要：目的运用超声造影成像探讨股动脉斑块新生血管与脑梗死的相关性,评价股动脉斑块稳定性对脑梗死的预测价值及其临床意义。资料与方法选取62例存在股动脉低回声斑块的患者进行回顾性研究,根据诊断结果分为脑梗死组和对照组,均行二维超声及超声造影成像,检测患者股动脉斑块最大厚度、横截面积狭窄率、斑块造影增强强度(EI)、曲线下面积(AUC)及斑块内新生血管分级情况等参数进行对比分析。结果脑梗死组的造影EI及AUC均高于对照组,差异有统计学意义(P<0.05);脑梗死组中III、IV级新生血管居多,对照组中I、II级新生血管居多,两组比较差异有统计学意义(P<0.05);而两组间的斑块最大厚度、横截面积狭窄率差异无统计学意义(P>0.05)。斑块内新生血管分级、EI和AUC均与脑梗死呈正相关(r=0.331、0.416、0.410,P<0.05)。结论 1利用超声造影成像检测脑梗死患者股动脉低回声斑块的特点为新生血管较丰富,斑块较不稳定。2股动脉低回声斑块新生血管情况与脑梗死的发生具有相关性,有望为临床预测及防治颅内动脉粥样硬化病变提供新方法。Purpose To evaluate the correlation between neovascularization in femoral artery plaque and cerebral infarction by using contrast enhanced ultrasound, and to assess the predictive value of femoral artery plaque stability in cerebral infarction and its clinical significance. Materials and Methods Sixty-two patients with femoral artery hypoechoic plaques were retrospectively studied. The patients were divided into cerebral infarction group and control group, and all of them underwent two-dimensional ultrasound and contrast enhanced ultrasound. The parameters such as the maximum thickness, the stenosis rate of cross-sectional area, the enhanced intensity （El）, the area under the curve （AUC） and the grading of the neovascularization in the plaque were detected and compared. Results The El and AUC of the cerebral infarction group were higher than those of the control group, the differences were statistically significant （P〈0.05）. Many grade IIl and IV neovascularizations were found in cerebral infarction group, while the grade I and II neovascularizations were mostly in the control group, the difference between the two groups was statistically significant （P〈0.05）. There were no significant differences in the maximum thickness and stenosis rate of cross-sectional area between the two groups （P〉0.05）. The neovascularization grade, El and AUC in the plaque were positively correlated with cerebral infarction （r=0.331, 0.416 and 0.410, P〈0.05）. Conclusion ① The chara-cteristics of femoral artery hypoechoic plaques in patients with cerebral infarction are rich of neovascularization and instable by using contrast-enhanced ultrasonic imaging. ② The neovascularization of femoral artery hypoechoic plaque has positive correlation with cerebral infarction, which may provide a new method for clinical prediction and prevention of intraeranial atherosclerosis.

关 键 词：动脉粥样硬化 股动脉 超声检查 多普勒 彩色 造影剂 新生血管化 病理性 脑梗死 

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