颈动脉粥样硬化斑块内新生血管超声造影特点的初步临床研究

Neovascularization within Carotid Atherosclerotic Plaques with Contrast-enhanced Ultrasonography Angiography——Preliminary Clinical Experience

目的 了解颈动脉粥样硬化斑块性质以及斑块内新生血管的特征，并分析新生血管的血液动力学特点。 方法 采用常规超声、彩色功率多普勒超声筛选出20例症状性颈动脉粥样硬化患者的29个斑块，应用超声造影技术对斑块进行检测，分析超声造影表现与斑块性质之间的关系、斑块内新生血管的分布特征、血液动力学特点。 结果 29个斑块中有28个斑块显示不同程度的增强，有9个斑块表现为造影剂单纯从管壁外向王迁块内增强，有6个斑块表现为造影剂单纯从管腔内向斑块内增强，另有13个斑块表现为造影剂从管腔内、管壁外周双向进入斑块内增强。在这些回声强度不同的斑块中，共5个硬斑块，其中4个硬斑块表现为造影剂从管壁外周向斑块内呈稀疏点状增强。在增强的28个癍块中软斑块9个，混合斑块15个，硬斑块4个。 结论 颈动脉超声造影可以实时、敏感地强化显示不同性质的颈动脉斑块，揭示颈动脉斑块内血液动力学特征。颈动脉超声造影是一种识别血块内新生血管的新技术。

Objective To observe composition of plaque and the features of neovascularization within human carotid atherosclerotic plaques with contrast-enhanced ultrasonography angiography. Methods Real-time contrast-enhanced ultrasonography（Contrast carotid duplex scanning） was performed in twenty patients with twenty-nine plaques of different degree of echogenicity. The features of plaques on contrast-enhanced ultrasonography were analyzed and compared with size and property of plaques. Results Twenty-eight plaques were enhanced on contrast-enhanced ultrasonography while nine plaques of them were enhanced from periphery of carotid wall to the center of the lesions with short-line pattern and thirteen plaques were enhanced from periphery of carotid wall and carotid lumen to the center of the lesions with sparse spots pattern, and six plaques were enhanced from carotid lumen to the center of the lesions with sparse spots pattern. Nine plaques of enhanced atherosclerotic plaques were soft plaque. Fifteen plaques were mixed plaque. One of five hard plaques was unenhanced plaque. Conclusion The real-time contrast-enhanced ultrasonography is a more sensitive and noninvasive way of demonstrating the hemodynamic of neovascularization within human carotid atherosclerotic plaques.