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超声造影灌注模式及血清脂质特征对易损性颈动脉斑块预测卒中的价值:一项中国患者颈动脉狭窄队列研究

Contrast-enhanced ultrasound perfusion patterns and serum lipid signatures of vulnerable carotid artery plaque in predicting stroke: A cohort study of carotid stenosis in Chinese patients.

作者信息

Huang Yunqian, Liu Qi, Xu Junmei, Zhu Wenqian, Jiang Jianwei, Tang Lei, Chen Man

机构信息

Department of Ultrasound, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Clin Hemorheol Microcirc. 2020;75(3):349-359. doi: 10.3233/CH-190804.

Abstract

BACKGROUND

Early identification of vulnerable plaques at risk of rupture could help prevent cerebral ischemic stroke in patients with carotid artery disease.

OBJECTIVE

To investigate the correlation between contrast-enhanced ultrasound (CEUS) perfusion patterns and serum lipid signatures of carotid artery plaques with the degree of carotid stenosis.

METHODS

A total of 80 patients with carotid artery plaques who underwent CEUS were included. All patients underwent CEUS, computed tomography angiography or digital subtraction angiography, and serum lipid testing.

RESULTS

The contrast agent enhancement levels and the CEUS perfusion patterns in the plaques were associated with the degree of carotid stenosis (P < 0.05). Serum free fatty acid (FFA) was associated with the contrast agent enhancement levels (P < 0.05), but did not correlate with the degree of stenosis (P > 0.05). There was no significant difference in total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides with respect to contrast agent enhancement levels (P > 0.05) or the degree of stenosis (P > 0.05).

CONCLUSION

A high level of CEUS perfusion and increased serum FFA levels are indicative of vulnerable carotid plaques, which may be useful for the prediction of stroke in patients with carotid artery disease.

摘要

背景

早期识别有破裂风险的易损斑块有助于预防颈动脉疾病患者的脑缺血性中风。

目的

探讨超声造影(CEUS)灌注模式与颈动脉斑块血清脂质特征及颈动脉狭窄程度之间的相关性。

方法

纳入80例行CEUS检查的颈动脉斑块患者。所有患者均接受CEUS、计算机断层血管造影或数字减影血管造影检查以及血脂检测。

结果

斑块内造影剂增强水平及CEUS灌注模式与颈动脉狭窄程度相关(P<0.05)。血清游离脂肪酸(FFA)与造影剂增强水平相关(P<0.05),但与狭窄程度无关(P>0.05)。总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及甘油三酯在造影剂增强水平(P>0.05)或狭窄程度方面无显著差异(P>0.05)。

结论

高水平的CEUS灌注及升高的血清FFA水平提示颈动脉易损斑块,这可能有助于预测颈动脉疾病患者的中风。

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