颈动脉粥样硬化斑块二维超声表现与斑块内微血管密度的相关性分析

The two dimensional ultrasonic performance of carotid atherosclerotic plaque and the correlation between mi-crovessel density in plaque

目的：观察不同类型颈动脉粥样硬化斑块的超声表现，分析与斑块内微血管密度的相关性。方法选取行颈动脉斑块剥离术治疗的患者87例，共发现斑块113块，所有患者行颈动脉彩色多普勒超声检查，分析斑块性质，对剥离的最大厚度斑块进行HE染色，计算斑块内血管密度，分析其与斑块超声表现的相关性。结果硬斑块、软斑块和混合斑块最大厚度分别为（0．49±0．05） mm、（0．36±0．08） mm和（0．39± 0.10）mm，截面积狭窄率分别为（88．32±6．51）％、（68．92±12．05）％和（71．95±13．04）％，差异均有统计学意义（F＝16．329和23．723，均P＜0．05），硬斑块最大厚度和截面积狭窄率均大于软斑和混合斑，差异均有统计学意义（t＝7．0917、2．501和6．452、6．086，均P＜0．05）；微血管密度值在三种斑块分别为（2．11±0．48）条／mm2、（5.91±1．03）条／mm2和（3．82±0．99）条／mm2，差异有统计学意义（F＝143．541，P＜0．05），软斑块＞混合斑块＞硬斑块，差异均有统计学意义（t＝6．579和9．392，均P＜0．05）；Pearson相关分析显示，软斑块的最大厚度和截面积狭窄率与斑块内微血管密度值之间均呈正相关（ r ＝0．372， P＝0．011；r ＝0．438， P＝0.000）。结论彩色多普勒超声检查可间接反映颈动脉斑块内微血管密度情况，可用于对颈动脉斑块易损性的初步评估。

Objective To investigate the ultrasonic performance of carotid atherosclerotic plaque and the correlation between microvessel density in plaque .Methods 87 cases of patients undergoing carotid artery plaque dissection were selected .113 plaques were found .All patients were taken carotid color Doppler sonography test and analysis of the plaque .The maximum thickness of plaques was taken HE stained ,and the vessel density in the plaque was counted .The correlation with sonographic performance of plaques was analyzed .Results The maximum plaque thicknesses in hard plaque ,soft plaque and mixed plaque were （0.49 ±0.05）mm,（0.36 ±0.08）mm and （0.39 ± 0.10）mm,respectively,and cross-sectional area stenosis rates were （88.32 ±6.51）%,（68.92 ±12.05）% and （71.95 ±13.04）%,respectively,the differences were statistically significant （F=16.329,23.723,all P〈0.05）. The maximum plaque thickness and cross -sectional area stenosis rate in hard plaque were all larger than soft plaque and mixed plaque,the differences were statistically significant （t=7.091 7,2.501 and 6.452,6.086,all P〈0.05）. The microvessel density values in different plaques were （2.11 ±0.48）strips/mm2,（5.91 ±1.03）strips/mm2 and （3.82 ±0.99）strips/mm2,the differences were statistically significant （F=143.541,P〈0.05）,soft plaque〉mixed plaques〉hard plaque,the differences were statistically significant （t=6.579 and 9.392,all P〈0.05）.Pearson cor-relation analysis showed that the maximum plaque thickness and cross -sectional area stenosis rate in soft plaque were positive correlation between microvascular density values （r=0.372,P=0.011;r=0.438,P=0.000）.Conclusion Color Doppler ultrasound examination might indirectly reflect microvessel densities in carotid artery plaque .It could be used preliminary assessment of vulnerability of carotid artery plaque .