Biasi G M, Sampaolo A, Mingazzini P, De Amicis P, El-Barghouty N, Nicolaides A N
Division of Vascular Surgery, Bassini Teaching Hospital, Italy.
Eur J Vasc Endovasc Surg. 1999 Jun;17(6):476-9. doi: 10.1053/ejvs.1999.0789.
to confirm that plaque echogenicity evaluated by computer analysis, as suggested by preliminary studies, can identify plaques associated with a high incidence of strokes.
a series of 96 patients with carotid stenosis in the range of 50-99% were studied retrospectively (41 with TIAs and 55 asymptomatic). Carotid plaque echogenicity was evaluated using a computerised measurement of the median grey scale value (GSM). All patients had a CT brain scan to determine the presence of infarction in the carotid territory.
the incidence of ipsilateral brain CT infarctions was 16% in the asymptomatic and 32% in the symptomatic plaques (p =0.076). It was 20% for <70% stenosis and 25% for >70% stenosis (p =0.52). It was 9% for plaques which had a GSM >50 and 40% in those with GSM <50 (p <0.001) with a relative risk of 4.6 (95% CI 1.8 to 11.6).
the results confirm that computer analysis of plaque echogenicity is better than the degree of stenosis in identifying plaques associated with an increased incidence of CT brain-scan infarction and consequently useful for identifying individuals at high risk of stroke. What is required is a form of image standardisation in order to apply this method to natural history studies with stroke as the endpoint.
正如初步研究所表明的，通过计算机分析评估斑块回声性，以确认其能否识别与高卒中发生率相关的斑块。
回顾性研究了96例颈动脉狭窄程度在50%-99%之间的患者（41例有短暂性脑缺血发作，55例无症状）。使用计算机测量中位数灰度值（GSM）来评估颈动脉斑块回声性。所有患者均进行了脑部CT扫描，以确定颈动脉供血区域是否存在梗死。
无症状斑块同侧脑部CT梗死发生率为16%，有症状斑块为32%（p = 0.076）。狭窄程度<70%的发生率为20%，>70%的为25%（p = 0.52）。GSM>50的斑块发生率为9%，GSM<50的为40%（p<0.001），相对风险为4.6（95%可信区间1.8至11.6）。
结果证实，在识别与脑部CT扫描梗死发生率增加相关的斑块方面，对斑块回声性进行计算机分析优于狭窄程度分析，因此有助于识别卒中高危个体。需要一种图像标准化形式，以便将该方法应用于以卒中为终点的自然史研究。
