Eur J Vasc Endovasc Surg. 2011 Sep;42 Suppl 1:S32-8. doi: 10.1016/j.ejvs.2011.06.022.
To correlate B-mode ultrasound findings to carotid plaque histology.
European multicentre study (nine centres).
Clinical presentation and risk factors were recorded and preoperative ultrasound Duplex scanning with special emphasis on B-mode imaging studies was performed in 270 patients undergoing carotid endarterectomy. Perioperatively, macroscopic plaque features were evaluated and the removed specimens were analysed histologically for fibrous tissue, calcification and 'soft tissue' (primarily haemorrhage and lipid).
Males had more soft tissue than females (p = 0.0006), hypertensive patients less soft tissue than normotensive (p = 0.01) and patients with recent symptoms more soft tissue than patients with earlier symptoms (p = 0.004). There was no correlation between surface description on ultrasound images compared to the surface judged intraoperatively by the surgeon. Echogenicity on B-mode images was inversely related to soft tissue (p = 0.005) and calcification was directly related to echogenicity (p < 0.0001). Heterogeneous plaques contained more calcification than homogeneous (p = 0.003), however, there was no difference in content of soft tissue.
Ultrasound B-mode characteristics are related to the histological composition of carotid artery plaques and to patient's history. These results may imply that patients with distant symptoms may be regarded and treated as asymptomatic patients whereas asymptomatic patients with echolucent plaques should be considered for carotid endarterectomy.
将颈动脉斑块的组织病理学与 B 型超声检查结果相关联。
欧洲多中心研究（9 个中心）。
记录临床症状和危险因素，并对 270 例行颈动脉内膜切除术的患者进行术前超声双功能扫描，特别强调 B 型成像研究。术中评估大体斑块特征，并对切除标本进行组织学分析，以确定纤维组织、钙化和“软组织”（主要是出血和脂质）的含量。
男性比女性有更多的“软组织”（p=0.0006），高血压患者比血压正常患者有更少的“软组织”（p=0.01），近期有症状的患者比早期有症状的患者有更多的“软组织”（p=0.004）。与术中外科医生判断的表面相比，超声图像上的表面描述没有相关性。B 型图像的回声强度与“软组织”呈负相关（p=0.005），钙化与回声强度呈正相关（p<0.0001）。不均匀斑块比均匀斑块含有更多的钙化（p=0.003），但“软组织”含量没有差异。
B 型超声特征与颈动脉斑块的组织学成分和患者的病史有关。这些结果可能意味着，有远处症状的患者可以被视为无症状患者，而回声减弱的无症状患者应考虑行颈动脉内膜切除术。
