Xu Xiangli, Hua Yang, Liu Beibei, Zhou Fubo, Wang Lili, Hou Weihong
Department of Ultrasound, the Second Hospital of Harbin, Harbin, People's Republic of China.
Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.
Ther Clin Risk Manag. 2021 Jul 1;17:679-690. doi: 10.2147/TCRM.S303485. eCollection 2021.
To investigate the relationship between calcification characteristics of carotid atherosclerotic plaque and lipid rich necrotic core (LRNC) and intraplaque hemorrhage (IPH).
Patients with severe carotid stenosis undergoing carotid endarterectomy (CEA) were selected. Ultrasound and CT angiography (CTA) were performed to evaluate the calcification characteristics of the plaque before the surgery.
A total of 142 patients were included and 142 pathological specimens of postoperative plaque were obtained accordingly. There were 78 plaques (54.9%) with LRNC and 41 (28.9%) with IPH. The plaque with LRNC had higher calcification rate (93.6%) compared with the plaque with IPH (87.8%). LRNC was often found in multiple calcification (P = 0.003) and mixed type calcification (P = 0.001). Multiple calcification was more likely to combine with IPH (P = 0.008), while simple basal calcification was not likely to combine IPH (P = 0.002). Smaller granular calcification was more likely to be associated with IPH (P < 0.05). In multivariate regression analysis of IPH and calcification characteristics, simple basal calcification was still a protective factor for IPH (OR, 0.25; 95% CI, 0.09-0.66; P = 0.005), while multiple calcification was closely related to the occurrence of IPH (OR, 3.58; 95% CI, 1.49-8.61; P = 0.004).
Calcification characteristics of carotid atherosclerotic plaques are closely related to the vulnerability of plaques, especially multiple calcification and mixed type calcification.
探讨颈动脉粥样硬化斑块钙化特征与富含脂质坏死核心（LRNC）及斑块内出血（IPH）之间的关系。
选取接受颈动脉内膜切除术（CEA）的重度颈动脉狭窄患者。术前采用超声和CT血管造影（CTA）评估斑块的钙化特征。
共纳入142例患者，相应获得142个术后斑块病理标本。有78个斑块（54.9%）存在LRNC，41个（28.9%）存在IPH。与存在IPH的斑块（87.8%）相比，存在LRNC的斑块钙化率更高（93.6%）。LRNC常见于多发钙化（P = 0.003）和混合型钙化（P = 0.001）。多发钙化更易合并IPH（P = 0.008），而单纯基底钙化不太可能合并IPH（P = 0.002）。较小的颗粒状钙化更易与IPH相关（P < 0.05）。在IPH与钙化特征的多因素回归分析中，单纯基底钙化仍是IPH的保护因素（OR，0.25；95%CI，0.09 - 0.66；P = 0.005），而多发钙化与IPH的发生密切相关（OR，3.58；95%CI，1.49 - 8.61；P = 0.004）。
颈动脉粥样硬化斑块的钙化特征与斑块易损性密切相关，尤其是多发钙化和混合型钙化。
