超声造影评价不同狭窄程度颈动脉粥样斑块内的新生血管形成

Contrast-enhanced ultrasound imaging of plaque stability in carotid arteries with different stenosis degree

目的评价灰阶谐波超声造影技术显示不同程度颈动脉狭窄患者动脉粥样硬化斑块内新生血管形成的价值。方法疑诊颈动脉狭窄患者58例，共73个斑块。常规超声评价颈动脉斑块回声类型，超声造影实时观察斑块内增强强度并进行分级。动脉狭窄程度以x线动脉造影检查结果为准。比较不同狭窄程度及不同回声类型颈动脉斑块的增强强度。结果颈动脉90％以下狭窄各组间斑块增强强度与动脉狭窄程度之间无相关性（P=0．358），但90％以上狭窄（包括闭塞）组斑块增强强度明显增加，两者之间差异有统计学意义（P=0．008）。不同斑块回声类型的斑块增强强度差异有统计学意义（P=0．000）。结论超声造影能够实时观察颈动脉粥样硬化斑块的增强过程，反映斑块内新生血管的形成，从而为评价斑块的稳定性提供重要信息。

Objective To evaluate contrast-enhanced ultrasound imaging of carotid atherosclerosis with different stenostic degree as a clinical tool to study intraplaque neovascularization. Methods Fifty-eight patients suspected of carotid stenosis with 73 plaques were studied By standard and contrast-enhanced ultrasound. Plaque echogenicity at standard ultrasound were evaluated. Contrast enhancement within the plaques was categorized as 0 - 4 degree and compared to the stenosis degree and the plaque echogenicity. The degree of stenosis was determined by intravenous digital subtraction angiography. Results In the group with stenosis less than 90%, stenosis degree was not associated with the grade of contrast enhancement （ P = 0. 358） ,while the grade of enhancement was significantly higher in the group with sever stenosis（〉90%）. The grades of enhancement were significantly different between plaques with different echogenicity （ P = 0. 000）. Conclusions Contrast-enhanced real-time ultrasound imaging can demonstrate the enhancement of carotid plaques non-invasively, which is helpful for assessing intraplaque neovascularization and provide valuable information for plaque risk stratification