Department of Internal Medicine, Section of Cardiology, Rush University Medical Center, Chicago, Ill, USA.
Radiology. 2011 Feb;258(2):618-26. doi: 10.1148/radiol.10101008. Epub 2010 Oct 22.
To correlate echogenicity and severity of atherosclerotic carotid artery lesions at standard ultrasonography (US) with the degree of intraplaque neovascularization at contrast material-enhanced (CE) US.
This HIPAA-compliant study was approved by the local ethics committee, and all patients provided informed consent. A total of 175 patients (113 [65%] men, 62 [35%] women; mean age, 67 years ± 10 [standard deviation]) underwent standard and CE US of the carotid artery. Lesion echogenicity (class I to IV), degree of stenosis, and maximal lesion thickness were evaluated for each documented atherosclerotic lesion. The degree of intraplaque neovascularization at CE US was categorized as absent (grade 1), moderate (grade 2), or extensive (grade 3). Correlation of neovascularization with echogenicity, degree of stenosis, and maximal lesion thickness was made by using Spearman ρ and χ(2) test for trend.
In a total of 293 atherosclerotic lesions, echogenicity was inversely correlated with grade of intraplaque neovascularization (ρ = -0.199, P < .001). More echolucent lesions had a higher degree of neovascularization compared with more echogenic ones (P < .001). The degree of stenosis was significantly correlated with grade of intraplaque neovascularization (ρ = 0.157, P = .003). Lesions with higher degree of stenosis had higher grade of neovascularization (P = .008), and maximal lesion thickness increased with the grade of neovascularization (P < .001) and was significantly correlated with grade of neovascularization (ρ = 0.233, P < .001).
Neovascularization visualized with CE US correlates with lesion severity and with morphologic features of plaque instability, contributing to the concept that more vulnerable plaques are more likely to have a greater degree of neovascularization. Therefore, CE US may be a valuable tool for further risk stratification of echolucent atherosclerotic lesions and carotid artery stenosis of different degrees.
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.10101008/-/DC1.
将标准超声（US）下颈动脉粥样硬化斑块的回声特征和严重程度与对比增强（CE）US 下斑块内新生血管化的程度相关联。
本 HIPAA 合规研究经当地伦理委员会批准，所有患者均签署知情同意书。共 175 例患者（113 例男性，62 例女性；平均年龄 67 岁±10 岁）行颈动脉标准 US 和 CE US 检查。记录每处粥样硬化病变，评估病变回声特征（I 至 IV 级）、狭窄程度和最大病变厚度。CE US 下斑块内新生血管化程度分为无（1 级）、中度（2 级）或广泛（3 级）。采用 Spearman ρ 和 χ²检验进行趋势分析，评估新生血管化与回声特征、狭窄程度和最大病变厚度之间的相关性。
在总共 293 处粥样硬化病变中，回声特征与斑块内新生血管化程度呈负相关（ρ=-0.199，P<0.001）。与回声较强的病变相比，回声较弱的病变新生血管化程度更高（P<0.001）。狭窄程度与斑块内新生血管化程度显著相关（ρ=0.157，P=0.003）。狭窄程度较高的病变新生血管化程度更高（P=0.008），最大病变厚度随新生血管化程度的增加而增加（P<0.001），且与新生血管化程度显著相关（ρ=0.233，P<0.001）。
CE US 显示的新生血管化与病变严重程度及斑块不稳定性的形态学特征相关，提示更易损的斑块更有可能出现更高程度的新生血管化。因此，CE US 可能是评估回声不均匀的粥样硬化病变和不同程度颈动脉狭窄的有价值的工具。
http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.10101008/-/DC1.
