超声检查对颈动脉粥样硬化血管重构的研究

Remodeling of carotid atherosclerosis by high resolution ultrasonography

目的 探讨颈动脉粥样硬化血管重构声像图改变。方法 对 88例颈动脉粥样硬化斑块形成患者应用体表超声测量颈动脉血管总面积、管腔面积、斑块面积、面积狭窄率和偏心指数。结果 斑块部位斑块面积与血管总面积正相关 ( r=0 .5 6 ,P <0 .0 5 ) ,与管腔面积无相关性 ,管腔面积与狭窄程度呈负相关 ( r=-0 .35 ,P <0 .0 5 )。当狭窄程度≤ 2 5 %时 ,管腔面积与狭窄程度无相关性 ,当狭窄程度 >2 5 %时 ,管腔面积与狭窄程度呈负相关 ( r =-0 .38,P <0 .0 5 )。软斑组血管总面积与斑块面积正相关( r=0 .6 6 ,P <0 .0 2 ) ,硬斑组血管总面积与斑块面积亦呈正相关 ( r =0 .5 9,P <0 .0 1)。向心性斑块组斑块面积与血管面积呈正相关 (r =0 .5 7,P <0 .0 1) ,与管腔面积无相关性 ,管腔面积与狭窄程度呈负相关 (r =-0 .6 3,P <0 .0 0 5 )。偏心性斑块组斑块面积与血管面积呈正相关 (r =0 .71,P <0 .0 1) ,与管腔面积无相关关系 ,管腔面积与狭窄程度呈负相关 ( r =-0 .46 ,P <0 .0 5 )。结论 高频体表超声可准确反映周围动脉粥样硬化血管重构像。

Objective To investigate the remodeling of carotid atherosclerosis varies in relation to composition and characters of plaque. Methods The carotid atherosclerosis was studied in 88 patients by high resolution ultrasonography. The plaque area, lumen area, vessel area, stenosis percentage and exocentric index were calculated at atherosclerotic lesion segments.Results There were significant correlation between the vessel area and plaque area ( r = 0.56 , P < 0.05 ) or the stenosis percentage and lumen area ( r = -0.35 , P < 0.05 ). When stenosis percentage was>25%, there was negative correlation between the stenosis percentage and lumen area; While stenosis percentage was ≤25% without correlation between them. In concentric plaque moderate correlation was revealed between the vessel area and plaque area ( r = 0.57 , P < 0.01 ) or the lumen area and stenosis percentage( r = -0.63 , P < 0.005 ). In exocentric plaque there was significant correlation between the vessel area and plaque area( r = 0.71 , P < 0.01 ) or stenosis percentage ( r = -0.46 , P < 0.05 ). No correlation existed between the plaque area and lumen area.Conclusions High resolution ultrasonography provides an accurate and reliable method for evaluating remodeling of the atherosclerosis of carotid arteries.