超声造影术在评价颈动脉粥样硬化斑块稳定性中的应用  

Application of contrast-enhanced ultrasonography in the evaluation of the stability of carotid atherosclerotic plaque

作　　者：邬文景[1] 贲志飞[1] 殷骅[1] 陈韵文 陈赛君[1] 付淑萍[1] 盛常睿[1] 郑哲岚[1] 

机构地区：[1]宁波市第二医院超声科,浙江省宁波315000

出　　处：《中国基层医药》2017年第15期2272-2276,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省宁波市卫生局项目（2014C0062）

摘　　要：目的 探讨超声造影术（CEUS）在评价颈动脉粥样硬化斑块（CAP）稳定性中的应用价值.方法 选择162例颈动脉粥样硬化斑块患者为研究组,选取同期34例颈动脉强回声斑块患者为对照组,采用彩色多普勒超声进行检查,观察患者颈动脉粥样硬化斑块情况.结果 研究组162例患者中脂质型、纤维型、钙化型和溃疡型斑块患者（21.60%、33.33%、34.57%和10.37%）均高于对照组（5.88%、2.94%、2.94%和2.94%）,差异均有统计学意义（χ^2=4.537、12.859、13.629和3.855,均P〈0.05）.研究组162例患者中软斑块患者75例,混合斑块患者36例,硬斑块患者51例,软斑组的新生血管分级36.00%、45.33%和10.33%高于混合斑组30.56%、41.67%和8.33%和硬斑组31.37%、13.72%和7.84%.软斑块组患者的峰值强度（-86.41±7.81）%、达峰时间（8.34±1.62）s、平均渡越时间（24.18±8.67）s明显低于混合斑块（-100.73±6.52）%、（9.79±2.14）s、（28.93±9.11）s和硬斑块患者（-104.14±6.15）%、（10.23±2.33）s、（30.07±9.48）s,差异有统计学意义（t=9.518、6.966、2.658、13.592、5.374、3.064,均P〈0.05）,而混合斑块和硬斑块患者比较,差异无统计学意义（P〉0.05）.CEUS诊断的斑块直径（4.13±0.75）mm显著大于常规超声的（3.62±1.14）mm,差异有统计学意义（t=4.757,P=0.000）.结论 超声造影可定性检测动脉粥样硬化斑块新生血管情况,能够进行斑块定量评估,评价斑块的稳定性,且灵敏度较高.Objective To study the application of contrast-enhanced ultrasonography （CEUS） in the evaluation of the stability of carotid atherosclerotic plaque （CAP）.Methods 162 patients with CAP were selected as study group.Meanwhile,34 patients with carotid artery strong echo plaques were selected as control group.The color doppler ultrasound was used to observe the CAP.Results The proportions of lipid type,fiber type,calcification and ulcer plaque in the study group were 21.60%,33.33%,34.57% and 10.37%,which were higher than those of the control group （5.88%,2.94%,2.94% and 2.94%）,the differences were statistically significant （χ^2=4.537,12.859,13.629 and 3.855,all P〈0.05）.There were 75 patients of soft plaques,36 patients with mixed plaques,51 patients with hard plaque in 162 patients.The new blood vessels classification in soft plaque group （36.00%,45.33% and 10.33%） were higher than the mixed plaque （30.56%,41.67% and 8.33%） and hard plaque group （31.37%,13.72% and 7.84%）.The peak intensity （-86.41±7.81） %,tmax （8.34±1.62）s,mean transit time （24.18±8.67）s in the soft plaque group were significantly lower than the mixed plaque [（-100.73±6.52）%,（9.79±2.14）s and （28.93±9.11）s] and hard plaque patients [（-104.14±6.15）%,（10.23±2.33）s and （30.07±9.48）s],the differences were statistically significant （t=9.518,6.966,2.658,13.592,5.374 and 3.064,all P〈0.05）,but there were no statistically significant differences between mixed plaque and hard plaque （all P〉0.05）.The plaque diameter （4.13±0.75）mm diagnosed by CEUS was significantly larger than that of conventional ultrasound [（3.62±1.14）mm],the difference was statistically significant （t=4.757,P=0.000）.Conclusion The CEUS can qualitatively detect the atherosclerotic plaque angiogenesis,can quantitatively assess plaque,evaluate the stability of the plaques,and the sensitivity is high.

关 键 词：超声检查 多普勒 彩色 血管造影术 动脉粥样硬化 稳定性 

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]