不同类型颈动脉斑块与新生血管关系的超声造影研究

Study on the relationship between of neovascularization within carotid atherosclerotic plaques with contrast-enhanced ultrasonography

目的 探讨颈动脉斑块不同类型与新生血管的关系。方法 运用实时超声造影技术对37例颈动脉粥样硬化患者的49个斑块进行检测，根据斑块类型分为软斑组（21个）、硬斑组（11个）和混合斑组（17个），分析造影表现与斑块类型之间的关系。结果 49个斑块中共有35个增强，其中19个软斑，13个混合斑，3个硬斑；未增强的14个斑块中，硬斑8个，混合斑4个，软斑2个。超声造影对软斑、混合斑、硬斑新生血管的检出率分别为90．47％（19／21）、76．47％（13／17）和27．27％（3／11）。超声造影对软斑组新生血管的检出率明显高于硬斑组（P=0．001），与混合斑组比较检出率差异无统计学意义（P=0．378）。结论实时超声造影可以较敏感地显示出斑块内新生血管的增强情况，斑块内新生血管的形成与斑块的性质密切相关。

Objective To explore the hemodynamics of neovascularization within human carotid atherosclerotic plaques with real-time contrast-enhanced ultrasonography. Methods Thirty-seven cases with forty-nine carotid atherosclerotic plaques were divided into three groups： group A,including 21 patients with carotid atherosclerotic soft plaques; group B, including 11 patients with hard plaques; group C, including 17 patients with mixed plaques, and which were examined with real-time contrast-enhanced ultrasonography. The features of plaques on contrast-enhanced ultrasonography were analysed and compared with size and property of plaques. Results Thirty-five atherosclerotic plaques were enhanced on contrast- enhanced ultrasonography. Among 35 enhanced plaques, 19 cases were soft plaque, 13 cases were mixed plaque,3 cases were hard plaque. While 14 unenhanced plaques,8 cases were hard plaque,4 cases were mixed plaque,2 cases were soft plaque. The detectable rate of neovascularization in soft plaque,mixed plaque and hard plaque by contrast-enhanced ultrasonography were 90.47% （ 19/21 ）, 76.47% （13/17） and 27.27% （3/11） ,respectively. The detectable rate of neovascularization in soft plaque was significantly higher than that in hard plaque（ P = 0. 001）, while the difference of the detectable rate between soft and mixed plaque has no statistic significance（ P = 0. 378）. Conclusions The real-time contrast-enhanced ultrasonography demonstrated dynamic enhancement of carotid atherosclerotic plaques more sensitively and revealed the hemodynamics of neovascularization within human carotid atherosclerotic plaques non-invasively, which was limited by thickness and property of plaque.