超微血管成像联合超声造影评估颈动脉斑块新生血管的应用价值研究  

An application study of ultravascular imaging combined with contrast-enhanced ultrasound to evaluate carotid plaque neovascularization

作　　者：李丽珍[1] 陈成彩 韦文娟 张淑名 曹兰芳 LI Lizhen;CHEN Chengcai;WEI Wenjuan;ZHANG Shuming;CAO Lanfang(Department of Medical Ultrasound,Affiliated Hospital of Youjiang Medical College for Nationalities,Baise,Guangxi 533000,China)

机构地区：[1]右江民族医学院附属医院超声医学科,广西百色533000

出　　处：《影像研究与医学应用》2023年第14期52-54,58,共4页Journal of Imaging Research and Medical Applications

基　　金：广西卫生健康委员会自筹经费科研课题(Z20200368);广西高校中青年教师科研基础能力提升项目(2022KY0539)。

摘　　要：目的:探讨超微血管成像(SMI)联合超声造影(CEUS)对颈动脉斑块内新生血管的诊断效能。方法:选取2020年6月—2023年7月在右江民族医学院附属医院就诊并行颈动脉斑块剥脱术的颈动脉狭窄患者70例,术前均行SMI和CEUS检查,术后以病理诊断为金标准,通过对比分析颈动脉斑块内新生血管强度分级,验证SMI联合CEUS应用对颈动脉斑块内新生血管的诊断效能。结果:70例颈动脉斑块患者行颈动脉内膜剥脱术(carotid endarterectomy,CEA)后,共获得颈动脉斑块91个,病理结果中易损斑块78个,稳定斑块13个。SMI与CEUS对颈动脉易损斑块的灵敏度、特异度和准确率分别为86.67%、75.00%、84.61%与90.91%、92.86%、91.21%。SMI联合CUES评估颈动脉易损斑块的灵敏度、特异度和准确率分别为94.87%、100.00%、95.60%。SMI联合CEUS评价易损斑块的诊断效能均高于单纯进行SMI或CEUS检测,差异具有统计学意义(P<0.01)。结论:SMI联合CEUS评价颈动脉斑块易损性的诊断效能更佳,可有效预测斑块的性质,为临床提供可靠的参考价值。Objective To investigate the diagnostic efficacy of ultramicroangiography(SMI)combined with contrast-enhanced ultrasound(CEUS)on neovascularization in carotid plaque.Methods From June 2020 to July 2023,70 patients with carotid artery stenosis who were treated in the Affiliated Hospital of Youjiang Medical College for Nationalities and accompanied by carotid plaque peeling were selected,and SMI and CEUS examinations were performed before surgery,and pathological diagnosis was taken as the gold standard after surgery,and the diagnostic efficacy of CEUS combined with SMI application in the neovascularization of carotid plaque was verified by comparative analysis of the intensity classification of neovascularization in carotid plaque.Results After carotid endarterectomy(CEA)in 70 patients with carotid endartery plaque,a total of 91 carotid plaques were obtained,and 78 fragile plaques and 13 stable plaques were obtained in the pathological results.The sensitivity,specificity and accuracy of MI and CEUS for carotid artery fragile plaques were 86.67%,75.00%,84.61%,90.91%,92.86%and 91.21%,respectively.The sensitivity,specificity and accuracy of SMI combined with CUES in assessing carotid artery vulnerable plaques were 94.87%,100.00%and 95.60%,respectively.The diagnostic efficacy of SMI combined with CEUS in evaluating vulnerable plaques was higher than that of SMI or CEUS alone,and the difference was statistically significant(P<0.01).Conclusion SMI combined with CEUS has better diagnostic efficacy in evaluating the vulnerability of carotid plaque,which can effectively predict the nature of plaque and provide reliable reference value for clinical practice.

关 键 词：超微血管成像 超声造影 颈动脉斑块 新生血管 

分 类 号：R445.1[医药卫生—影像医学与核医学]