超声造影时间-强度曲线评价颈动脉粥样硬化斑块内新生血管与冠心病的关系

Relationship between carotid atherosclerotic plaques neovascularization and coronary heart disease by time-intensity curve of contrast-enhanced ultrasound

目的:探讨超声造影时间-强度曲线评价颈动脉粥样硬化斑块内新生血管与冠心病(CHD)的关系。方法:78例颈动脉粥样硬化患者根据冠状动脉(冠脉)造影结果分为冠脉正常组(23例)、单支病变组(27例)和多支病变组(28例),常规超声观察各组患者的颈动脉斑块类型,肉眼观察斑块内造影剂灌注情况,使用声学定量分析软件(SonoLiver)对图像进行脱机分析,计算斑块达峰时间(TTP)、最大峰值强度比(IMAX%)和曲线下面积(AUC),并进行组间比较,量化分析颈动脉粥样硬化斑块内的新生血管与CHD的相关关系。结果:CHD多支病变组软斑例数和颈动脉粥样硬化斑块内新生血管均多于单支病变组和正常组,各组间TTP、IMAX%、AUC均差异有统计学意义(均P<0.01)。结论:超声造影时间-强度曲线量化评价颈动脉粥样硬化斑块内新生血管,能够作为CHD危险程度的预测指标之一。

Objective：To investigate the correlation between carotid atherosclerotic plaques neovascularization and coronary heart disease （CHD） by time-intensity curve of contrast-enhanced ultrasound. Method： Seventy-eight cases of carotid atherosclerosis were divided into three groups： coronary artery normal group （23 cases）, CHD single lesion group （27 cases） and CHD muhivessel lesions group （28 cases）. Plaque types of all patients with carotid atherosclerosis were observed by conventional ultrasound. Time to peak （TTP）, the ratio of Maximum Intensity （IMAX%） and area under the curve （AUC） of carotid plaques were calculated with time-intensity curve analysis software （SonoLiver） through real-time contrast-enhanced ultrasound. The relationship between neovascularization within plaque and CHD was analyzed. Result：The soft plaque incidence and neovascularization of carot id atherosclerotie plaques in CHD muhivessel lesions group were higher than those in CHD single lesion group and normal group. There were significant differences in TTP, IMAX%, and AUC （all P〈0.01） among three groups. Conclusion： Time-intensity curve of contrast-enhanced ultrasound can be used as a predictor of CHD through quantitating carotid atherosclerosis plaque neovascularization.