超声在颈动脉血栓诊断及鉴别诊断中的应用价值

Application value of ultrasound in diagnosis and differential diagnosis of carotid artery thrombus

目的分析颈动脉血栓超声特点及其与动脉硬化斑块的鉴别诊断。方法颈部动脉超声检查的患者41417例,颈动脉血栓患者行CT或MRI检查,并超声随访。结果41417例中,检出血栓870例,检出率2.10%。其中血栓呈无回声2例,低回声393例,等回声195例,混合回声280例。附壁血栓9例,血栓性闭塞或近闭塞42例,颈动脉硬化斑块合并血栓性闭塞或近闭塞819例。颈动脉血栓和血栓合并斑块的男性患者均较女性患者少,附壁血栓组和血栓性闭塞组的患者年龄较血栓合并斑块组小,差异均有统计学意义(P<0.01)。结论超声检查可以用于颈动脉血栓的诊断,并与颈动脉硬化斑块鉴别,为临床的诊治提供依据。

Objective To analyze the ultrasonic features of carotid artery thrombus and its differential diagnosis with arteriosclerosis plaque. Methods Forty - one thousand four hundred and seventeen patients were examined by carotid artery ultrasound. The patients with carotid artery thrombus were further examined by CT and MRI and followed - up by ultrasonography. Results Eight hundred and seventy of 41417 cases were found with carotid artery thrombus （870/41417, 2.1% ） by ultrasound, 2 were anechoic, 393 were hypoechoic, 195 were iso - echoic ,280 were mixed echoic. The patients included 9 cases of adherent thrombus, 42 cases of occlusion or nearly occlusion and 819 cases of occlusion or nearly occlusion combined with arteriosclerosis plaque. Compared with male patients, More female had carotid artery thrombus and thrombus combined with plaque. The patients with adherent thrombus and occlusion were younger than those with thrombus combined with plaque. Conclusion Color Doppler ultrasound can diagnose carotid artery thrombus effectively, and discriminate with arteriosclerosis plaque, it also can provide more information for clinical diagnosis and therapy.