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[超微血管成像在诊断颈动脉易损斑块中的价值]

[Value of Superb Micro-vascular Imaging in Diagnosing Carotid Artery Vulnerable Plaque].

作者信息

Xie Xia, Bai Zhi-Yong, Liu Yue, Zhang Hua-Bin

机构信息

Department of Ultrasound,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2018 Aug 30;40(4):444-449. doi: 10.3881/j.issn.1000-503X.10424.

Abstract

Objective To explore the diagnostic value of superb micro-vascular imaging (SMI) for patients with vulnerable plaque of carotid artery. Methods Totally 69 patient with carotid hypoechoic or predominantly hypoechoic plaque (108 plaques),which were identified by conventional ultrasound,underwent SMI and contrast-enhanced ultrasound (CEUS). Based on the scores of CEUS and SMI (0,1,and 2 points),the consistency of SMI and CEUS in detecting plaque neovascularization was assessed. Results SMI could more clearly display the profile and morphology of the plaques than conventional ultrasound. SMI showed that there were neovascularization in 75 plaques,and CEUS showed that there were neovascularization in 76 plaques;the number of scoring consistency in the plaque neovascularization under SMI and CEUS was 90,suggesting these two results were highly consistent (Kappa value=0.748). There were 6 ulcerated carotid plaques detected by SMI,and the same 6 ulcerated carotid plaques were detected by CEUS,showing complete consistency. Of these 108 plaques,55 caused stenosis of the lumen,and SMI showed there was no correlation between plaque neovascularization and stenosis of the lumen caused by plaques (P=0.473). Conclusion SMI can clearly display the morphology and outline of the plaques and the plaque neovascularization. Therefore,it can be used for evaluating plaque vulnerability.

摘要

目的 探讨超微血管成像(SMI)对颈动脉易损斑块患者的诊断价值。方法 选取69例经传统超声检查发现有颈动脉低回声或以低回声为主的斑块(共108个斑块)的患者,对其进行SMI及超声造影(CEUS)检查。根据CEUS和SMI的评分(0分、1分和2分),评估SMI与CEUS在检测斑块新生血管方面的一致性。结果 SMI比传统超声能更清晰地显示斑块的轮廓和形态。SMI显示75个斑块有新生血管,CEUS显示76个斑块有新生血管;SMI与CEUS在斑块新生血管评分的一致性数量为90,提示两者结果高度一致(Kappa值=0.748)。SMI检测出6个颈动脉溃疡斑块,CEUS也检测出同样的6个颈动脉溃疡斑块,显示完全一致。在这108个斑块中,55个导致管腔狭窄,SMI显示斑块新生血管与斑块导致的管腔狭窄之间无相关性(P=0.473)。结论 SMI能清晰显示斑块的形态、轮廓及斑块新生血管情况。因此,可用于评估斑块易损性。

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