超声多模态声像图特征及各参数值与脑卒中颈动脉斑块易损性的相关性  

Correlation between multimodal ultrasound image characteristics and parameter values and vulnerability of carotid artery plaques in stroke

作　　者：陈薇[1] 郑建华[1] 方荔香 陈振东[1] 陈海兰[1] 翁育娟[1] 曾宸 Chen Wei;Zheng Jianhua;Fang Lixiang;Chen Zhendong;Chen Hailan;Weng Yujuan;Zeng Chen(Department of Ultrasound,Affiliated Hospital of Putian University,Putian,Fujian 351100,China)

机构地区：[1]莆田学院附属医院超声科,福建莆田351100

出　　处：《齐齐哈尔医学院学报》2025年第1期65-69,共5页Journal of Qiqihar Medical University

基　　金：莆田市科技计划项目(2021S3F003)。

摘　　要：目的探究超声多模态声像图特征及各参数值与脑卒中颈动脉(CAS)斑块易损性的相关性。方法选择2020年3月—2021年3月本院收治的240例脑卒中颈动脉粥样硬化(Carotid artery arhrosclerosis,CAS)患者作为研究对象,以冠脉造影斑块形态将CAS患者分为易损斑块组(n=76)和稳定斑块组(n=164)两组。采用二维超声、超微血管成像、剪切波弹性成像及超声造影对患者斑块特征进行评估,比较两组患者IMT、斑块积分、CAS狭窄程度、脑血流量与颈动脉血流量差异,并分析易损斑块组和稳定斑块组剪切波弹性成像杨氏模量参数和超声造影参数的变化,采用受试者工作特征(ROC)曲线评估超声多模态声像图特征及参数值联合应用对脑卒中颈动脉斑块易损性的诊断价值。结果与易损斑块组相比,稳定斑块组患者颈动脉硬化斑块面积以及IMT均明显增高,差异具有统计学意义(P<0.05)。与易损斑块组相比,稳定斑块组患者的CCA、ICA、VA狭窄度明显升高,差异均具有统计学意义(P<0.05)。与易损斑块组相比,稳定斑块组患者脑血流量和颈动脉血流量均明显降低,差异具有统计学意义(P<0.05)。易损斑块患者的达峰时间少于稳定斑块患者的时间(P<0.05),易损斑块患者的最大峰值强度高于稳定斑块患者的强度(P<0.05)。易损斑块患者的平均杨氏模量、最大及最小杨氏模量均高于稳定斑块患者(P<0.05)。单因素分析结果显示,两组CEUS增强、SMI新生血管、表面形态和钙化结节比较差异具有统计学意义(P<0.05),狭窄率、斑块回声和斑块极低回声区组件比较,差异无统计学意义(P>0.05)。表面形态(SMI)、CEUS增强、钙化结节及联合诊断鉴别斑块易损性的ROC曲线下面积分别为0.658、0.722、0.681和0.836。结论超声多模态声像图特征及各参数值与脑卒中颈动脉斑块易损性的相关性,其中超声多模态声像图特征及参数值联合应用对脑卒中颈Objective To explore the correlation between the characteristics and parameter values of multimodal ultrasound images and the vulnerability of carotid artery plaques in stroke.Methods Two hundred and forty stroke patients with carotid artery atherosclerosis(CAS)treated from March 2020 to March 2021 at our hospital were selected as study subjects.Patients were divided into a vulnerable plaque group(n=76)and a stable plaque group(n=164)based on the morphology of coronary angiography plaques.Plaque characteristics were assessed using two-dimensional ultrasound,ultrafine vascular imaging,shear wave elastography,and contrast-enhanced ultrasound.Differences in intima-media thickness(IMT),plaque score,CAS stenosis degree,cerebral blood flow,and carotid artery blood flow were compared between the two groups.Changes in Young's modulus parameters and contrast-enhanced ultrasound parameters in shear wave elastography for vulnerable and stable plaque groups were analyzed.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of the combined application of multimodal ultrasound features and parameter values for the vulnerability of carotid artery plaques in stroke.Results Compared with the vulnerable plaque group,the stable plaque group had significantly increased carotid artery atherosclerotic plaque area and IMT,with statistically significant differences(P<0.05).The stenosis of the common carotid artery(CCA),internal carotid artery(ICA),and vertebral artery(VA)in the stable plaque group was significantly higher than in the vulnerable plaque group(P<0.05).Cerebral blood flow and carotid artery blood flow in the stable plaque group were significantly lower than in the vulnerable plaque group(P<0.05).The time to peak was shorter in vulnerable plaque patients than in stable plaque patients(P<0.05),and the maximum peak intensity was higher in vulnerable plaque patients than in stable plaque patients(P<0.05).The average Young's modulus,maximum,and minimum Young's modulus in vulnerable plaque pat

关 键 词：超声多模态 脑卒中 颈动脉斑块 斑块易损性 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]