增强型能量多普勒成像技术对颈动脉粥样斑块稳定性评价及其对脑梗死的预测价值

E-Flow Doppler Imaging Technology Evaluating Stability of Carotid Atherosclerotic Plaques and Its Predictive Value to Cerebral Infarction

目的探讨增强型能量多普勒(E-Flow)成像技术对颈动脉粥样斑块稳定性评价的可行性及其对脑梗死的预测价值。方法应用E-Flow成像技术对81例颈动脉粥样硬化患者的斑块进行检查,根据斑块内部回声特点,将其分为软斑(41例)、硬斑(15例)及混合斑(25例),观察斑块内E-Flow显像特点。根据斑块内有无血流信号,再将患者分为斑块内有血流组(59例)和无血流组(22例),比较两组间脑梗死发生率。在斑块内有血流组中,比较脑梗死与非脑梗死患者的血流动力学。结果 81例患者中,共有59例患者的斑块可探及血流信号,其中软斑38例(占64.4%),混合斑21例(占35.6%),硬斑内未见明显血流信号。斑块内有血流组脑梗死发生率(76.3%)显著高于无血流组(40.9%),差异有统计学意义(P<0.05)。斑块内有血流组中,脑梗死与非脑梗死患者的血流动力学参数间差异无统计学意义(P>0.05)。结论 E-Flow成像能显示粥样斑块内有血流与脑梗死有关,提示该技术可以作为评价颈动脉粥样硬化斑块稳定性的方法之一,并可初步预测脑梗死的发生。

Objective To explore the feasibility of E-flow imaging technology evaluating stability of carotid atherosclerotic plaques（CAP） and its predictive value to cerebral infarction（CI）.Methods A total of 81 CAP patients examined by E-flow imaging technology were divided,based on plaque internal echo characteristics,into groups soft plaque（n=41）,hard（n=15） and mixed（n=25）,to observe the internal E-flow imaging characteristics.And according to blood flow signal within plaques,the patients were re-divided into groups blood-flow（n=59）,non-blood-flow（n=22）,and the incidences of CI were compared between 2 groups.The hemodynamics was compared between CI and non-CI patients in blood-flow group.Results In 81 patients,blood flow signals were detected in plaques of 59 patients,including 38 soft（64.4%）,21 mixed（35.6%）,and no obvious signal detected in hard plaques.The CI incidence of blood-flow group was 76.3%,significantly higher than that of non-blood-flow group（40.9%）,the difference was significant（P0.05）.No significant difference was noted in hemodynamic parameter between CI and non-CI patients in blood-flow group（P0.05）.Conclusion E-flow imaging can show that blood flow in atherosclerotic plaques is related to CI,suggesting that this technology can be used as one of the methods of evaluation of carotid atherosclerotic plaque stability and predict primarily CI occurrence.