Lisowska A, Knapp M, Tycinska A, Sawicki R, Kralisz P, Lisowski P, Sobkowicz B, Musial W I
Department of Cardiology, Medical University of Bialystok, Bialystok, Poland -
Int Angiol. 2014 Feb;33(1):50-7.
Contrast-enhanced ultrasound imaging of the carotid arteries (CECU) permits direct, real-time visualization of neovascularization in atherosclerotic plaques and is a confirmed predictor of unstable atheromatous lesions. The aim of the study was the assessment of a new, automatically measured index of intensity in quantitative estimation of the contrast flow through the carotid plaque (till now assessed only visually).
Forty-four patients (mean age 70.4±11.4) with ultrasound diagnosed significant stenosis of internal carotid artery (ICA), after cerebrovascular or cardiovascular events, qualified for carotid artery stenting (CAS) were examined. The carotid ultrasound examinations with contrast agent Sonovue were performed.
Visually in 22 patients (50%) contrast flow through the atherosclerotic plaques was found. In 17 patients (38.6%) massive, calcified atherosclerotic plaques were present. Patients with preserved contrast flow through the plaque more frequently had a history of cerebral stroke (P=0.04). Massive calcifications of atherosclerotic plaques correlated with a previous MI (P=0.03) and the degree of advancement of coronary artery disease (P=0.04), but not with a previous cerebral stroke. Contrast flow through the atherosclerotic plaque positively correlated with values of the index of intensity (r=0.69, P<0.00001). In patients with preserved contrast flow the mean value of the index of intensity was 22.24±3.55 dB as compared with 12.37±7.67 dB - a value present in patients without preserved contrast flow. No significant relation for the degree of calcifications and the value of the index of intensity was found.
The assessment of the index of intensity is a novel, simple and automatic method to estimate the degree of contrast flow through the carotid plaque. The values of the index of intensity correlate with the contrast flow through the atherosclerotic plaque, but not with its calcification.
颈动脉超声造影成像（CECU）可直接、实时观察动脉粥样硬化斑块内的新生血管形成，是不稳定动脉粥样硬化病变的确诊预测指标。本研究旨在评估一种新的、自动测量的强度指数，用于定量评估通过颈动脉斑块的造影剂血流（此前仅通过视觉评估）。
对44例（平均年龄70.4±11.4岁）经超声诊断为颈内动脉（ICA）严重狭窄、发生过脑血管或心血管事件且符合颈动脉支架置入术（CAS）条件的患者进行检查。采用造影剂声诺维进行颈动脉超声检查。
在22例（50%）患者中通过视觉观察发现有造影剂血流通过动脉粥样硬化斑块。17例（38.6%）患者存在大量钙化的动脉粥样硬化斑块。造影剂血流通过斑块的患者更常发生过脑卒中（P=0.04）。动脉粥样硬化斑块的大量钙化与既往心肌梗死（P=0.03）及冠状动脉疾病进展程度（P=0.04）相关，但与既往脑卒中无关。通过动脉粥样硬化斑块的造影剂血流与强度指数值呈正相关（r=0.69，P<0.00001）。造影剂血流通过的患者强度指数平均值为22.24±3.55 dB，而造影剂血流未通过的患者该值为12.37±7.67 dB。未发现钙化程度与强度指数值之间存在显著相关性。
强度指数评估是一种新颖、简单且自动的方法，用于估计通过颈动脉斑块的造影剂血流程度。强度指数值与通过动脉粥样硬化斑块的造影剂血流相关，但与斑块钙化无关。
