超声造影三维成像评价颈动脉软斑块内新生血管的初步研究

Preliminary study on evaluation of neovascularization within carotid soft plaques with contrast-enhanced three dimensional ultrasonography

目的 探讨超声造影三维成像评价颈动脉软斑块内新生血管的临床价值.方法 对36例颈动脉粥样硬化患者的42个软斑块进行超声造影二维成像和超声造影三维成像,根据图像中斑块内造影剂的分布、形态等特点将斑块内新生血管情况分为4级：Ⅰ级,斑块内无增强;Ⅱ级,斑块内呈星点状增强或仅局部小范围增强;Ⅲ级,斑块内呈点状和短条状增强;Ⅳ级,斑块内呈条状和网络状增强.结果 超声造影二维成像模式下42个软斑块中,Ⅰ级2个（占4.8%）,Ⅱ级15个（占35.7%）,Ⅲ级22个（占52.4%）,Ⅳ级3个（占7.1%）;超声造影三维成像模式下42个软斑块中,Ⅰ级0个,Ⅱ级4个（占9.5%）,Ⅲ级20个（占47.6%）,Ⅳ级18个（占42.9%）.结论 超声造影三维成像可以更全面地反映颈动脉软斑块内新生血管的空间分布特点,为进一步研究斑块立体解剖结构及整体微血管灌注情况提供一种新的方法.

Objective To investigate the clinical value of contrast-enhanced three-dimensional ultrasound in assessing neovascularization within carotid soft plaques. Methods Thirty-six cases with 42 soft plaques were examined with contrast-enhanced two dimensional ultrasound and contrast-enhanced three dimensional ultrasound. Soft plaques were divided into four grades according to distribution and shape of contrast media：grade Ⅰ （there was no enhancement in plaque） , grade Ⅱ （plaque was enhanced with sparse spots pattern or enhanced in small range locally）, grade Ⅲ （plaque was enhanced with sparse spots and short-line pattern ）,grade Ⅳ （plaque was enhanced with line and grid pattern）. Results The results of contrast-enhanced two-dimensional ultrasound were as followed： 4.8% grade Ⅰ , 35.7% grade Ⅱ , 52.4% grade Ⅲ and 7.1% grade Ⅳ. The results of contrast-enhanced three-dimensional ultrasound were as followed：9.5% grade Ⅱ , 47.6% grade Ⅲ and 42.9% grade Ⅳ. Conclusions Spatial distribution of neovascularization within carotid soft plaques could be reflected comprehensively by contrast-enhanced three dimensional ultrasound, and it might be a new mothod to investigate spatial structure and microvascular perfusion of soft plaques furtherly.