颈动脉不稳定斑块的影像学评估与组织病理学的对比研究  

Comparative Study of Imaging and Histopathology in Unstable Carotid Plaque

作　　者：王晓曦 侯慧卿[1] 刘艳宁 叶玉泉[1] Wang Xiaoxi;Hou Huiqing;Liu Yanning;Ye Yuquan(Department of Ultrasound Physical,Hebei General Hospital,Shijiazhuang 050000,China;Department of Neurosurgery,980 Hospital of PLA Joint Logistic Support Force,Shijiazhuang 050000,China)

机构地区：[1]河北省人民医院体检超声科,石家庄市050000 [2]解放军联勤保障部队第980医院神经外科,石家庄市050000

出　　处：《中国超声医学杂志》2022年第12期1337-1340,共4页Chinese Journal of Ultrasound in Medicine

基　　金：2021政府资助临床医学优秀人才培养项目(No.2021046)。

摘　　要：目的 探讨实时剪切波弹性成像(SWE)与超声造影(CEUS)对动脉硬化斑块易损性评估的准确度。方法 纳入72例行颈动脉内膜剥脱术(CEA)的患者,术前行超声检查、SWE及CEUS检查,对斑块的易损性进行初步判定。术后将斑块组织进行病理切片,评估影像学检查对于易损斑块预测的准确度。结果 (1)不稳定斑块杨氏模量明显低于稳定斑块,造影峰值强度高于稳定斑块组,差异有统计学意义(P<0.01)。(2)根据受试者工作特征(ROC)曲线,CEUS诊断截断值为2.41 dB,SWE诊断截断值为30.25 kPa。结论 CEUS技术及SWE技术对颈动脉斑块可进行量化分析,对不稳定斑块有预测价值。Objective To discuss the accuracy of shear wave elastography(SWE) and contrast enhanced ultrasound(CEUS) in assessing the vulnerability of atherosclerotic plaque. Methods 72 patients undergoing carotid endarterectomy(CEA) were included.Preoperative ultrasonography, SWE and CEUS were performed to determine the vulnerability of plaque. Postoperative pathological sections of plaque tissue were analyzed to evaluate the accuracy of imaging examination in predicting the vulnerability of plaques. Results(1)Young’s modulus of unstable plaque was significantly lower than stable plaque, and contrast intensity was higher than stable plaque group(P<0.01).(2)According to the receiver operating characteristic(ROC) curve, the diagnostic cut-off value of CEUS was 2.41 dB,and that of SWE was 30.25 kPa. Conclusions CEUS and SWE can be used for quantitative analysis of vulnerability in carotid plaque and has predictive value for unstable plaques.

关 键 词：颈动脉斑块 超声造影 剪切波弹性成像 动脉内膜剥脱术 

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]