高分辨率彩色多普勒超声检测颈动脉斑块726例分析

High-resolution color Doppler ultrasonography for screening carotid atherosclerotic plaque

目的探讨高分辨率彩色多普勒超声对动脉粥样硬化斑块性质的识别,及对血管腔狭窄程度的评估。方法采用高分辨彩超,对726例颈动脉斑块患者进行纵横扫查颈总动脉和颈内及颈外动脉起始部斑块,观测其回声性质、大小、管腔狭窄程度及彩色多普勒血流频谱参数。结果726例中29.89%(217/726)为混合斑,28.93%(210/726)为软斑,26.17%(190/726)为扁平斑,15.01%(109/726)为硬斑;颈总动脉分叉膨大部和颈内动脉起始部为斑块的好发部位,左右两侧发生斑块的差异无显著性意义(P>0.5);检出管腔狭窄68例,轻度狭窄占35.29%(24/68),中度狭窄52.94%(36/68),重度狭窄11.76%(8/68);颈总动脉内径男性大于女性,右侧大于左侧,差异有非常显著性意义(P<0.0001)。结论高分辨率彩超能准确识别颈动脉粥样硬化斑块的性质、评估血管狭窄的程度,能为临床心脑血管疾病的早期干预和治疗及对外科手术和介入治疗提供客观依据。

Objective We prospectively detected 726 patients with carotid atherosclerotic plaque by using high-resolution Doppler ultrasonography to explore the characteristics of atherosclerotic plaque and to assess the degree of carotid artery stenosis. Methods The common carotid artery and the origin of the internal carotid artery and the external carotid artery were examined with high-resolution Doppler ultrasonography to evaluate the atherosclerotic plaque and carotid stenosis.Results The features of atherosclerotic plaque were as follows: 29.89%(217/726) with the commixing plaque,28.93%(210/726)with the plaques of fibrous cap and fatty,26.17%(190/726)with the flat plaques of fatty sites,15.01%(109/726)with the calcified plaques; The plaques were common in the bifurcation. The carotid stenosis was found in 68 patients, in which, 24 with mild stenosis, 36 with moderate stenosis, 8 with severe stenosis. Conclusion High-resolution Doppler ultrasonography plays a pivotal role in assessing the features and changes of sonography of carotid atherosclerosis plaque, and thus is attribute to prevent or treat cardiovascular and cerebrovascular diseases.