Miskolczi L, Guterman L R, Flaherty J D, Hopkins L N
Department of Neurosurgery, State University of New York at Buffalo, School of Medicine and Biomedical Sciences 14209, USA.
AJNR Am J Neuroradiol. 1996 Nov-Dec;17(10):1881-90.
To evaluate the ability of intravascular sonography to depict plaque ulceration and to identify the limitations of and the artifacts associated with this technique.
Twenty-eight human carotid arteries were mounted in a pulsatile flow chamber and examined with intravascular sonography. We compared 140 intravascular sonograms with gross pathologic and histologic sections. Ulcerations with a diameter or depth of at least 0.5 mm were sought.
All eight arteries with ulcerated plaques and nine of 10 individual ulcerations were depicted by intravascular sonography. One artery (one of 140 arterial cross sections) with a small mural thrombus was misinterpreted as ulcerated. Our intravascular sonographic measurements underestimated the gross ulceration dimensions by 22% (depth) and 17% (orifice diameter).
Intravascular sonography is highly accurate for the diagnosis of plaque ulceration. The central position of the high-frequency transducer within the target vessel facilitates high resolution of the arterial lumen-wall border, permitting more powerful definition of small ulcerations than available by other diagnostic methods. However, the utility of invasive intravascular sonography for detecting carotid ulcerations cannot be determined until the pathologic significance of plaque ulceration is clearly defined.
评估血管内超声描绘斑块溃疡的能力，并确定该技术的局限性及相关伪像。
将28条人类颈动脉安装在脉动血流腔中，并用血管内超声进行检查。我们将140幅血管内超声图像与大体病理和组织学切片进行了比较。寻找直径或深度至少为0.5毫米的溃疡。
血管内超声描绘出了所有8条有溃疡斑块的动脉以及10个单个溃疡中的9个。1条有小壁血栓的动脉（140个动脉横截面中的1个）被误判为溃疡。我们的血管内超声测量低估了大体溃疡尺寸，深度低估22%，开口直径低估17%。
血管内超声对斑块溃疡的诊断具有高度准确性。高频换能器在目标血管内的中心位置有助于高分辨率显示动脉腔-壁边界，比其他诊断方法能更清晰地界定小溃疡。然而，在斑块溃疡的病理意义明确之前，无法确定有创血管内超声检测颈动脉溃疡的实用性。
