Department of Medical Ultrasound, Peking Union Medical College Hospital, Beijing, China.
Department of Medical Ultrasound, Maternal and Child Health Care Hospital of Tongzhou District, Beijing, China.
Vasc Med. 2020 Aug;25(4):328-333. doi: 10.1177/1358863X20909992. Epub 2020 Apr 17.
The objective of this study was to investigate the correlation between the amount of blood flow in the area of neovascularization within a carotid atherosclerotic plaque by superb microvascular imaging (SMI) and the microvessel density (MVD) determined by histopathological staining. Twenty-eight carotid atherosclerotic plaques were detected by SMI in 28 patients who underwent carotid endarterectomy. SMI was graded according to the visual methods as follows: grade I: no appearance of neovascularization within the plaque; grade II: punctate neovascularization; grade III: one or two linear neovascularizations within the plaque; and grade IV: multiple (> 2) linear neovascularizations throughout the plaque. The neovascularization density was determined by the CD31 complex staining method. There was a significant correlation between the density of neovascularization in histopathologic plaques and the blood flow grade found by SMI ( = 0.788, < 0.001). A significant difference was observed in SMI blood flow grade between the symptomatic and asymptomatic groups (χ = 2.634, = 0.036). The MVD of plaques in the symptomatic group was significantly higher than that in the asymptomatic group ( = 2.530, = 0.018). The SMI-based classification was positively correlated with plaque thickness. SMI, which is a new nonultrasound contrast-enhanced imaging method, can effectively evaluate neovascularization in carotid atherosclerotic plaques and can be used as a novel method for the clinical prediction of stroke risk.
本研究旨在探讨通过超微血流成像（SMI）检测颈动脉粥样硬化斑块内新生血管化区域血流与组织病理学染色确定的微血管密度（MVD）之间的相关性。28 例颈动脉内膜切除术患者的 28 个颈动脉粥样硬化斑块通过 SMI 检测。SMI 根据以下视觉方法进行分级：I 级：斑块内无新生血管出现；II 级：点状新生血管；III 级：斑块内出现 1 或 2 条线性新生血管；IV 级：斑块内出现多个（>2 个）线性新生血管。新生血管密度通过 CD31 复合物染色方法确定。组织病理学斑块中的新生血管密度与 SMI 发现的血流分级之间存在显著相关性（ = 0.788， < 0.001）。SMI 血流分级在有症状和无症状组之间存在显著差异（χ = 2.634， = 0.036）。有症状组斑块的 MVD 明显高于无症状组（ = 2.530， = 0.018）。基于 SMI 的分类与斑块厚度呈正相关。SMI 是一种新的非超声对比增强成像方法，可有效评估颈动脉粥样硬化斑块内的新生血管化，并可作为预测卒中风险的一种新方法。
