超微血管成像对颈动脉斑块内新生血管评价及危险因素分析  

Evaluation of neovascularization in carotid artery plaque using super micro-vascular imaging and analysis of its risk factors

作　　者：杜阳春[1] 王小燕[1] 郑红雨[1] 许春梅[1] 胡巧[1] 蓝春勇[1] 张云 韦旋[2] Du Yangchun;Wang Xiaoyan;Zheng Hongyu;Xu Chunmei;Hu Qiao;Lan Chunyong;Zhang Yun;Wei Xuan(Department of Ultrasound,the People’s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi ,China;Department of Neurologic Medicine,the People’s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi ,China)

机构地区：[1]广西壮族自治区人民医院超声科,广西南宁530021 [2]广西壮族自治区人民医院神经内科,广西南宁530021

出　　处：《右江民族医学院学报》2019年第3期260-263,共4页Journal of Youjiang Medical University for Nationalities

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2016761)

摘　　要：目的探讨超微血管成像(Super Micro-vascular Imaging,SMI)评估颈动脉斑块内新生血管的价值,并对相关危险因素进行分析。方法 选取常规超声发现颈动脉粥样硬化斑块患者46例,所有患者均接受SMI及超声造影(Contrast Enhanced Ultrasound,CEUS)检查,评价SMI与CEUS检查结果的一致性,并详细记录患者的基线临床资料及检查结果。结果 SMI与CEUS评分有较好的一致性(Kappa=0.508,P<0.05)。SMI和CEUS检测到的大部分新生血管位于同一位置。以CEUS评分为诊断标准,SMI评分的受试者工作特征(Receiver Operating Characteristic curve,ROC)曲线下面积达0.895,P<0.05,SMI评分诊断斑块内新生血管的敏感度88%,特异度80%。对可能的相关危险因素进行Logistic回归分析发现:脑梗病史、高水平总胆固醇、三酰甘油、低密度脂蛋白胆固醇、同型半胱氨酸是斑块内新生血管形成的危险因素(P<0.05);根据Spearman秩相关分析发现SMI评分与总胆固醇、三酰甘油、低密度脂蛋白胆固醇、同型半胱氨酸呈正相关(P<0.05)。结论 SMI是检测颈动脉斑块内新生血管便捷、有效的技术;脑梗病史、高水平总胆固醇、三酰甘油、低密度脂蛋白胆固醇、同型半胱氨酸是斑块内新生血管形成的危险因素。Objective To investigate the value of super micro-vascular imaging(SMI)in evaluating neovascularization in carotid artery plaque and analyze its risk factors.Methods Forty-six patients with carotid artery atherosclerotic plaques detected by conventional ultrasound were selected,and all patients received SMI and contrast enhanced ultrasound(CEUS)examinations.The consistency of SMI and CEUS test results was evaluated,and the baseline clinical data and test results of patients were recorded in detail.Results SMI and CEUS scores had good consistency(Kappa=0.508,P<0.05).Most of the new blood vessels detected by SMI and CEUS were located in the same site.Taking CEUS score as the diagnostic standard,the area under the receiver operating characteristic curve(ROC)of SMI score was up to 0.895,P<0.05.The sensitivity and specificity of SMI score in diagnosing plaque neovascularization were 88%and 80%respectively.Logistic regression analysis for possible risk factors showed that the history of cerebral infarction,high levels of total cholesterol,triacylglycerol,low-density lipoprotein(LDL)cholesterol and homocysteine were risk factors for plaque neovascularization(P<0.05).According to Spearman rank correlation analysis,SMI scores were positively correlated with total cholesterol,triglycerides,LDL cholesterol and homocysteine(P<0.05).Conclusion SMI is a convenient and effective technique to detect carotid plaque neovascularization.The history of cerebral infarction,higher level of total cholesterol,triglycerides,LDL cholesterol and homocysteine were risk factors for carotid plaque neovascularization.

关 键 词：超微血管成像 颈动脉 斑块 动脉粥样硬化 新生血管 危险因素 超声造影 

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]