颈动脉硬化斑块成分的影像量化分析

Ultrasound densitometry analysis of human carotid plaque components

目的探讨在体、体外颈动脉粥样硬化斑块的超声影像表现与斑块内病理成分的相关性,并对超声图像进行灰度值量化分析。方法对经过动脉内膜切除术的20例颈动脉狭窄患者的22条血管行术前和术后标本的超声检查,记录主要斑块的形态及特点,斑块标本沿与纵轴垂直方向做不同层面的病理切片,将斑块超声影像与病理切片相匹配,分析在体、体外斑块内纤维组织、脂质、钙化、出血及血栓的超声表现,将各种病理成分的超声影像用256级灰度值进行量化。结果在体斑块中钙化、纤维组织、出血/血栓、脂质的超声影像灰度值分别为89±12、53±8、37±6和39±3,体外斑块中上述不同成分的超声影像灰度值分别为168±11、136±12、85±12和89±10,钙化、纤维组织与出血/血栓、脂质灰度值有显著性差异。结论灰度值分析可以对动脉硬化斑块中不同病理成分的超声影像进行量化处理,为判定斑块的稳定性提供客观依据。

Objective To correlate the ultrasound irmaging of atherosclerotic carotid in vivo and in vitro with the histological analysis, and to evaluate the usefulness of gray scale ultrasound densitometry analysis of ultrasound images. Methods Twenty-two carotid plaque lesions of 20 patients were examined by high resolution B-mode ultrasound pre-and post operatively, and the images of carotid plaque were quantitatively analyzed by 256 gray scale ultrasound densitometry. The transverse pathological sections of the plaques were made, and matched and compared with the images of ultrasound. Results Ultrasound density measurement of calcium, fibrous tissue, hemorrhage / thrombus and lipid deposits was 89±12, 53±8, 37±6, and 39±3 respectively in vivo, and was 168±11, 136±12, 85±12 and 89±10 respectively in vitro. Besides the comparison between hemorrhage and lipid deposits, there were significant statistic differences of density measurement between different components. Conclusions Gray scale ultrasound densitometry analysis can provide quantitative measure- ment of atherosclerotic carotid plaque, and is useful for evaluate the stability of the plaque.