Micropure技术检测颈动脉斑块微钙化的初步临床应用  

Identification of carotid plaque microcalcification by Micropure imaging

作　　者：何英[1] 叶丹[2] 华飞[3] 练学淦[2] 吴坚[2] 蒋颖[2] 岳春贤 杨松[2] 魏宁[2] 刘猛[2] He Ying Ye Dan Hua Fei Lian Xuegan Wu Jian Jiang Ying Yue Chunxian Yang Song Wei Ning Liu Meng(Department of Ultrasound, Third Affiliated Hospital, Soochow University, Changzhou 213003, China Department of Neurology, Third Affiliated Hospital, Soochow University, Changzhou 21300？, China Department of Endocrinology, Third Affiliated Hospital, Soochow University, Changzhou 213003, China)

机构地区：[1]苏州大学附属第三医院超声科,常州213003 [2]苏州大学附属第三医院神经内科,常州213003 [3]苏州大学附属第三医院内分泌科,常州213003

出　　处：《中华神经医学杂志》2017年第10期1056-1059,共4页Chinese Journal of Neuromedicine

基　　金：江苏省社会发展项目(BE2016659);常州市社会发展项目(CE20165026)

摘　　要：目的研究颈动脉斑块微钙化与缺血性脑卒中（包括短暂性脑缺血发作）的关系及其对缺血性脑卒中事件的预测价值。方法连续收集自2016年11月至2017年3月苏州大学附属第三医院神经内科收治的符合韩国改良TOAST分型的动脉粥样硬化血栓形成型患者26例，采取Micropure技术检测双侧颈动脉微钙化情况，以Alberta卒中CT（ASPECT）评分评估颅内缺血性病变严重程度，分析微钙化发生情况与ASPECT评分的关系。采取受试者工作特征曲线（ROC）评估颈动脉微钙化对发生缺血性脑卒中事件的预测价值。结果Micropure技术提示有19例患者27条颈动脉出现微钙化，其中位于纤维帽处23个（85.19%），位于斑块基底部4个（14.81%）。纤维帽处23个微钙化中位于大钙化边缘的有14个（51.85%）。微钙化颈动脉侧ASPECT评分为（10.85±1.43）分，无微钙化颈动脉侧ASPECT评分为（11.80±1.19）分，差异有统计学意义（t=2.584，P=0.013）。ROC曲线下面积为0.673，灵敏度0.667，特异度0.680，提示评估颈动脉微钙化对缺血性脑卒中事件的发生具有一定的预测价值。结论Micropure技术可以应用于颈动脉微钙化检测，微钙化侧颈动脉区域更易发生缺血性脑卒中事件。ObjectiveTo explore the relationship between carotid plaque microcalcifcation and ischemic stroke （including transient ischemic attack） and the value of carotid microcalcification in predicting ischemic stroke.MethodsTwenty-six patients in accordance with atherothrombosis models classified by Korean modified TOAST classification were enrolled in this study from November 2016 to March 2017. The microcalcification of the bilateral carotid was detected by Micropure imaging and the severity of intracranial ischemic focal lesions was evaluated by Alberta stroke programme early CT scale （ASPECT）. The relation of ASPECT scores with microcalcification of the bilateral carotid was analyzed, and the value of carotid microcalcification in predicting ischemic stroke was analyzed by receiver operating characteristic curve method.ResultsMicrocalcifition was detected in 27 of the total 52 carotids （51.92%） in 19 patients, which localized in the fibrous cap in 23 carotids （85.19%） and the basilar part of the plaque in 4 carotids （14.81%）. The microcalcification surrounded the macrocalcifiation in 14 carotids （51.85%）. The ASPECT scores were 10.85±1.43 in the microcalcifition side, which were significantly higher than those in the side without microcalcifition （11.80±1.19, t=2.584, P=0.013）. The area under the curve was 0.673, with sensitivity of 0.667 and specificity of 0.680.ConclusionMicropure imaging maybe a new approach to detect the carotid microcalcification, and plaques with microcalcifition may easily cause ipsilateral ischemic stroke.

关 键 词：颈动脉 微钙化 超声 脑卒中 Micropure技术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]