Zhang Q, Li C, Han H, Dai W, Shi J, Wang Y, Wang W
School of Communication and Information Engineering, Shanghai University, 200072, Shanghai, China.
Department of Ultrasound, Zhongshan Hospital, Fudan University, 200032, Shanghai, China.
Eur J Vasc Endovasc Surg. 2015 Sep;50(3):289-96. doi: 10.1016/j.ejvs.2015.06.077. Epub 2015 Jul 23.
OBJECTIVE/BACKGROUND: To evaluate whether carotid intraplaque neovascularization (IPN) can be accurately assessed by two types of quantitative analysis on contrast enhanced ultrasound (CEUS), the time intensity curve analysis and the analysis of contrast agent spatial distributions, and whether the quantitative analysis correlates with semiquantitative visual interpretation and histopathology.
Forty-four plaques in 34 patients were included for CEUS examination. A three point score system (absent, moderate, and extensive) was used for semiquantitative grading of IPN. Eight spatial quantitative parameters were derived, including the IPN area ratio in plaque (AR) and the AR in plaque core (AR13). Two temporal quantitative parameters were obtained, namely the enhanced intensity in plaque (EI) and the enhanced intensity ratio (EIR). Histopathology with CD34 staining for quantification of microvessel density (MVD) was performed on 12 plaques excised by carotid endarterectomy.
Both spatial and temporal parameters were correlated with MVD on histology (AR: r = .854; AR13: r = .858; EI: r = .767; EIR: r = .750 [p < .01]), as well as with semiquantitative grading (p < .01). Five mutually independent factors were condensed from 10 interrelated parameters by using factor analysis, and they significantly predicted MVD with an radj value as high as .932 (p = .01).
Both spatial and temporal analysis on CEUS can accurately assess IPN. Combining them provides better IPN assessment and may be useful for plaque vulnerability evaluation and risk stratification.
目的/背景：评估对比增强超声（CEUS）的两种定量分析方法，即时间强度曲线分析和造影剂空间分布分析，能否准确评估颈动脉斑块内新生血管形成（IPN），以及定量分析是否与半定量视觉解读和组织病理学相关。
纳入34例患者的44个斑块进行CEUS检查。采用三点评分系统（无、中度、广泛）对IPN进行半定量分级。得出8个空间定量参数，包括斑块内IPN面积比（AR）和斑块核心内的AR（AR13）。获得2个时间定量参数，即斑块内增强强度（EI）和增强强度比（EIR）。对通过颈动脉内膜切除术切除的12个斑块进行组织病理学检查，用CD34染色定量微血管密度（MVD）。
空间和时间参数均与组织学上的MVD相关（AR：r = 0.854；AR13：r = 0.858；EI：r = 0.767；EIR：r = 0.750 [p < 0.01]），也与半定量分级相关（p < 0.01）。通过因子分析从10个相关参数中浓缩出5个相互独立的因素，它们显著预测MVD，调整后R值高达0.932（p = 0.01）。
CEUS的空间和时间分析均可准确评估IPN。将两者结合可提供更好的IPN评估，可能有助于斑块易损性评估和风险分层。
