Kardoulas D G, Katsamouris A N, Gallis P T, Philippides T P, Anagnostakos N K, Gorgoyannis D S, Gourtsoyannis N C
Department of Radiology, University of Crete Medical School, Herakleion University Hospital, Greece.
Cardiovasc Surg. 1996 Oct;4(5):580-90. doi: 10.1016/0967-2109(96)00030-0.
The purpose of the study was to determine the reliability of ultrasonography in assessing plaque pathology and to relate it to clinical symptoms. Ten symptom-free patients and 26 with symptomatic carotid plaques with a stenosis > 70%, as detected by arteriography, were assessed by duplex. The findings were compared with the clinical presentation and plaque pathology. Pathological specimens of the plaque that had < 60% fibrous tissue were associated with an increased incidence of past stroke (P = 0.002). Plaque ulceration, haemorrhage and calcium were all unrelated to the clinical presentation. Using the pathological specimen as the 'gold standard', ultrasonography was unable to detect plaque ulceration or haemorrhage. Plaque regularity, irregularity, homogeneity and heterogeneity were not consistent with plaque pathology or the clinical presentation. The fibrous tissue was significantly greater (73%) in plaques with an echogenic character compared with those with an echolucent morphology (63%; P = 0.04). Moreover, echolucent plaques were most common in symptomatic patients and echogenic plaques in symptom-free patients (P = 0.002).
本研究的目的是确定超声检查在评估斑块病理学方面的可靠性，并将其与临床症状相关联。对10名无症状患者和26名有症状的颈动脉斑块患者（经动脉造影检测，狭窄>70%）进行了双功超声评估。将结果与临床表现和斑块病理学进行比较。纤维组织<60%的斑块病理标本与既往中风发生率增加相关（P = 0.002）。斑块溃疡、出血和钙化均与临床表现无关。以病理标本作为“金标准”，超声检查无法检测到斑块溃疡或出血。斑块的规则性、不规则性、均匀性和不均匀性与斑块病理学或临床表现不一致。与呈无回声形态的斑块（63%）相比，呈回声增强特征的斑块中的纤维组织明显更多（73%；P = 0.04）。此外，无回声斑块在有症状的患者中最常见，而回声增强斑块在无症状患者中最常见（P = 0.002）。
