el-Barghouty N, Geroulakos G, Nicolaides A, Androulakis A, Bahal V
Academic Vascular Unit, St Mary's Hospital Medical School, London, UK.
Eur J Vasc Endovasc Surg. 1995 May;9(4):389-93. doi: 10.1016/s1078-5884(05)80005-x.
To determine the relationship between plaque echogenicity as measured by computer and the incidence of cerebral brain infarction.
Eighty-seven patients with 148 plaques producing more than 50% internal carotid artery stenosis were studied. Sixty-nine plaques were in asymptomatic patients, 35 were associated with amaurosis fugax, 19 with transient ischaemic attacks and 25 with stroke. All patients had a CT brain scan and the presence of ipsilateral cerebral infarction was noted. Images of the plaques obtained with an ATL Ultramark-4 Duplex scanner (7.5 MHz high resolution probe) were transferred to a computer. Using an image analysis program a histogram for each plaque was obtained with the number of pixels plotted against the grey scale (0-225). The median of the grey scale was used as a measure of echogenicity.
Fifty-three (36%) of the 148 plaques were associated with ipsilateral CT brain infarction. Plaques with a grey scale median more than 32 (echogenic) were associated with an incidence of 11% (7/64) CT infarction. In contrast, plaques with grey scale median below or equal to 32 (echolucent) were associated with 55% (46/84) incidence of CT infarction (chi 2 = 30.35, p < 0.001, relative risk = 22, 95% confidence interval from 4.7 to 108).
This study indicates that computer analysis of carotid plaque can identify high-risk carotid plaques. The potential of such analysis in the identification of asymptomatic high-risk patients should be explored in further studies.
确定通过计算机测量的斑块回声性与脑梗死发生率之间的关系。
对87例患有148个导致颈内动脉狭窄超过50%的斑块的患者进行了研究。69个斑块见于无症状患者，35个与一过性黑矇相关，19个与短暂性脑缺血发作相关，25个与中风相关。所有患者均进行了脑部CT扫描，并记录同侧脑梗死的存在情况。使用ATL Ultramark - 4双功扫描仪（7.5 MHz高分辨率探头）获得的斑块图像被传输到计算机。使用图像分析程序获得每个斑块的直方图，其中像素数量相对于灰度（0 - 225）绘制。灰度中位数用作回声性的度量。
148个斑块中有53个（36%）与同侧脑部CT梗死相关。灰度中位数大于32（高回声）的斑块与CT梗死发生率11%（7/64）相关。相比之下，灰度中位数低于或等于32（低回声）的斑块与CT梗死发生率55%（46/84）相关（χ² = 30.35，p < 0.001，相对风险 = 22，95%置信区间为4.7至108）。
本研究表明，对颈动脉斑块进行计算机分析可识别高危颈动脉斑块。这种分析在识别无症状高危患者方面的潜力应在进一步研究中进行探索。
