Yoshida S, Hirata K, Fukuda M
Department of Ultrasound and Medical Diagnosis, Sapporo Medical College.
J Cardiol Suppl. 1991;26:37-44.
This study was designed to assess semi-quantitative ultrasonic evaluation of atherosclerotic lesions with high resolution transesophageal ultrasound. Various types of atherosclerotic lesions were differentiated using transesophageal ultrasound in 51 samples from 20 specimens of fresh descending aorta of humans or other animals in vitro, and in 62 patients in vivo. Microscopic examination of normal, fatty plaque, fibro-fatty plaque, fibrous plaque, calcified lesion and ulcerative lesion apparently coincided with transesophageal ultrasound images of normal (0), intimal irregular thickening (degree of I), intimal protuberance with low and high echo density in the plaque (II), high echo density in the plaque having an additional echo layer in the medial layer (III), irregular intimal thickening with calcification and ulcerative lesion with low and high mixed echo (IV). The quality of ultrasound image obtained from the patients in vivo proved similar to that obtained during the in vitro studies, and in addition six ulcerative lesions including two with torn intima were detected with transesophageal echocardiography. These results demonstrate that high resolution transesophageal ultrasound is an excellent approach to detect semiquantitatively atherosclerotic lesions of the aorta in vitro and in vivo.
本研究旨在通过高分辨率经食管超声对动脉粥样硬化病变进行半定量评估。使用经食管超声对来自20例人或其他动物新鲜降主动脉标本的51个样本进行体外研究,并对62例患者进行体内研究,以区分各种类型的动脉粥样硬化病变。对正常、脂肪斑块、纤维脂肪斑块、纤维斑块、钙化病变和溃疡性病变的显微镜检查结果与经食管超声图像明显相符,分别为正常(0级)、内膜不规则增厚(I级)、斑块内低回声和高回声密度的内膜隆起(II级)、斑块内高回声密度且中层有额外回声层(III级)、伴有钙化的不规则内膜增厚以及低回声和高回声混合的溃疡性病变(IV级)。体内患者获得的超声图像质量与体外研究中获得的图像质量相似,此外,经食管超声心动图检测到6例溃疡性病变,其中2例伴有内膜撕裂。这些结果表明,高分辨率经食管超声是在体外和体内半定量检测主动脉粥样硬化病变的一种优秀方法。