Leeds Vascular Institute, The General Infirmary at Leeds, Leeds LS1 3EX, United Kingdom.
Eur J Vasc Endovasc Surg. 2010 Feb;39(2):134-8. doi: 10.1016/j.ejvs.2009.11.003. Epub 2009 Nov 25.
Attempts to stratify carotid plaques according to clinical risk using single longitudinal view (SLV) echomorphology have not been uniformly successful. We compared SLV grey scale median measurements (SLV-GSM) with a newer technique of multiple cross-sectional view echomorphology (MCSV-GSM) in carotid plaques from 3 patient groups (asymptomatic, ocular, and hemispheric symptoms).
SLV and MCSV images were obtained from 109 carotid stenoses (70-99%; 41 hemispheric, 17 ocular, 51 asymptomatic). SLV-GSM and MCSV-GSM(min) (lowest plaque MCSV image GSM) were determined to assess echolucency whilst MCSV-GSM(max-min) (highest minus lowest MCSV-GSM) assessed heterogeneity.
Echolucency was greater (lower GSM) in plaques causing hemispheric symptoms versus asymptomatic plaques (MCSV-GSM(min), P = .002; SLV-GSM, P = .002). Only MCSV imaging detected differences in echolucency between asymptomatic plaques and those causing ocular symptoms (SLV-GSM, p = 0.84; MCSV-GSM(min), p = .003). Symptomatic plaques showed greater heterogeneity versus asymptomatic plaques, significantly in those causing ocular symptoms (hemispheric P = .126; AF P = .011).
Both SLV and MCSV echomorphology confirm increased echolucency in plaques causing hemispheric symptoms. Plaques causing ocular symptoms could only be distinguished from asymptomatic plaques with MCSV assessment (increased echolucency and heterogeneity). This suggests that amaurosis fugax may be associated with a more focal plaque instability that is best detected with MCSV imaging.
根据单一切面（SLV）回声形态学使用临床风险对颈动脉斑块进行分层的尝试并不总是成功的。我们比较了来自 3 组患者（无症状、眼部和半球症状）的颈动脉狭窄（70-99%；41 例半球症状、17 例眼部症状、51 例无症状）的 SLV 灰度中位数测量值（SLV-GSM）和一种新的多切面回声形态学技术（MCSV-GSM）。
从 109 个颈动脉狭窄部位（70-99%；41 个半球症状、17 个眼部症状、51 个无症状）获得 SLV 和 MCSV 图像。确定 SLV-GSM 和 MCSV-GSM(min)（最低斑块 MCSV 图像 GSM）以评估回声不透明度，而 MCSV-GSM(max-min)（最高减去最低 MCSV-GSM）评估异质性。
引起半球症状的斑块回声不透明度更高（GSM 更低），与无症状斑块相比（MCSV-GSM(min)，P =.002；SLV-GSM，P =.002）。只有 MCSV 成像检测到无症状斑块和引起眼部症状的斑块之间回声不透明度的差异（SLV-GSM，p = 0.84；MCSV-GSM(min)，p =.003）。与无症状斑块相比，有症状的斑块显示出更大的异质性，在引起眼部症状的斑块中差异显著（半球 P =.126；AF P =.011）。
SLV 和 MCSV 回声形态学均证实引起半球症状的斑块回声不透明度增加。只有通过 MCSV 评估才能将引起眼部症状的斑块与无症状斑块区分开来（回声不透明度和异质性增加）。这表明一过性黑矇可能与更局部的斑块不稳定有关，而 MCSV 成像最能检测到这种不稳定。
