Department of Echocardiography, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200080, China.
Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200080, China.
BMC Med Imaging. 2019 Aug 23;19(1):74. doi: 10.1186/s12880-019-0374-9.
This study evaluates carotid vulnerable plaques using contrast-enhanced ultrasound (CEUS) and explores the relationship between vulnerable plaques and leukocytes.
Sixty-two symptomatic and 54 asymptomatic patients underwent CEUS. The images were analyzed using time-intensity and fitting curves, and peak (P), mean (M), peak (P), sharpness (S), and area under the curve (AUC) were obtained. The relations between CEUS parameters and leukocytes were analyzed.
In the symptomatic group, total leukocytes and neutrophils were higher, while lymphocyte was decreased; P, M, P, S, and AUC were significantly higher; M and AUC were negatively correlated with lymphocytes, and M was positively correlated with neutrophils. Classification and regression tree analysis showed that M at a cutoff of 20.8 and AUC at a cutoff of 8.8 resulted in a predictive of acute cerebral infarction, accuracy of 84.3%, sensitivity of 87.1%, and specificity of 81.5%.
The variation in the perivascular leucocyte is significantly related to intraplaque inflammatory activities, CEUS is a feasible monitor of intraplaque neovascularization, so CEUS combined with perivascular leucocyte could be helpful as a warning for vulnerable plaques.
本研究采用超声造影（CEUS）技术评估颈动脉易损斑块，并探讨易损斑块与白细胞的关系。
对 62 例有症状患者和 54 例无症状患者进行 CEUS 检查。应用时间-强度曲线及拟合公式分析图像，获得峰值（P）、平均强度（M）、斜率（S）、曲线下面积（AUC）等参数。分析 CEUS 参数与白细胞的相关性。
在有症状组中，总白细胞和中性粒细胞较高，淋巴细胞减少；P、M、P、S 和 AUC 显著增加；M 和 AUC 与淋巴细胞呈负相关，M 与中性粒细胞呈正相关。分类回归树分析显示，M 值为 20.8，AUC 值为 8.8 时对急性脑梗死有预测价值，准确率为 84.3%，敏感度为 87.1%，特异度为 81.5%。
斑块周白细胞的变化与斑块内炎症活动明显相关，CEUS 是斑块内新生血管的一种可行的监测方法，因此，CEUS 结合斑块周白细胞计数可能有助于作为易损斑块的预警指标。
