血管超声造影评估颈动脉斑块强化模式与脑梗死的相关性研究  

Study on the correlation between the enhance patterns of carotid plaque and cerebral infarction by contrast-enhance ultrasound

作　　者：陈巧琼[1] 丁尚伟[1,2] 谢玉环[1] 李润雄[3] 谢燕铧 刘佩君 Chen Qiaoqiong;Ding Shangivei;Xie Yuhuan;Li Runxion;Xie Yanhua;Liu Peijun(Department of Ultrasound, Dongguan People's Hospital Affiliated to Southern Medical University, Dongguan 523059 , China;Department of Ultrasound, the First Affiliated Hospital of Guangzhou Medical Universitv,Guangzhou 510120 China;Department of Neurology,Dongguan People's Hospital Affiliated to Southern Medical University, Dongguan 523059, China)

机构地区：[1]南方医科大学附属东莞人民医院超声科,523059 [2]广州医科大学附属第一医院超声科,510120 [3]南方医科大学附属东莞人民医院神经内科,523059

出　　处：《中国医师杂志》2019年第3期339-343,共5页Journal of Chinese Physician

基　　金：东莞市社会发展重点项目(2016108101031)~~

摘　　要：目的探讨脑梗死患者颈动脉斑块对比增强成像特点及强化模式。方法选择颈动脉斑块患者进行研究,根据有无脑梗死分为两组:脑梗死患者54例共62个斑块进行对比增强成像,纳入A组;无脑梗死患者48例共54个斑块进行超声造影,纳入B组。根据斑块强化程度将斑块分为1～4级。根据斑块内造影剂的来源,将斑块的强化模式分为血管外膜强化、血管腔强化、混合强化。分析两组患者的颈动脉斑块强化级别和强化模式有无差异。结果脑梗死组患者颈动脉斑块强化以3级(26/62)和4级(22/62)强化为主,无脑梗死组患者颈动脉斑块强化以2级(20/54)和3级(20/54)为主,两组之间2级强化斑块的比例差异有统计学意义(P=0. 019),4级强化斑块的比例差异有统计学意义(P=0. 041)。脑梗死组斑块血管外膜强化模式(27/59)比例低于无脑梗死组(37/50),差异有统计学意义(P=0. 003),混合强化模式比例则明显高于无脑梗死组,差异有统计学意义(P=0. 003)。结论脑梗死患者颈动脉斑块对比增强成像强化明显,混合强化模式多见,提示血管腔与斑块相通可能是发生脑梗死的重要原因。Objective To investigate the characteristics and the enhanced patterns of carotid plaque using contrast-enhanced ultrasound (CEUS) and patients with cerebral infarction. Methods The patients with carotid plaque were divided into two groups according to whether they had cerebral infarction: 54 patients(62 plaques with CEUS) with cerebral infarction were included in group A, and 48 patients (54 plaques with CEUS) without cerebral infarction were included in group B. The plaques were divided into four grades according to the degree of plaque enhancement. According to the source of intraplaque contrast agents, plaque enhancement patterns were divided into adventitia enhancement, lumen enhancement and mixed enhancement. To analyze the degree and pattern of carotid plaque enhancement in the two groups. Results Carotid plaque enhancement in cerebral infarction group was mainly grade 3(26/62) and grade 4(22/62), while that in non-cerebral infarction group was mainly grade 2(20/54) and grade 3(20/54). There was significant difference between the two groups in the proportion of carotid plaque enhancement of grade 2 (P=0.019) and grade 4 (P=0.041). The proportion of plaque adventitia enhancement model in group A(27/59) was lower than that in group B(37/50), with statistically significant difference (P=0.003). While the proportion of mixed enhancement mode in group A was significantly higher than that in group B (P=0.003). Conclusions The enhancement of carotid plaque was obvious in cerebral infarction patients, and the mixed enhancement pattern was more common. It suggested that the communication between vascular cavity and plaque might be an important factor leading to cerebral infarction.

关 键 词：血管造影术:颈动脉疾病 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] R743.3[医药卫生—诊断学]