颈动脉斑块内新生血管的超微血管显像:与超声造影对比

Superb microvascular imaging in neovascularization within carotid plaques:Compared with contrast enhanced ultrasound

目的探讨应用超微血管显像(SMI)技术检测斑块内新生血管的可行性。方法选择25例经常规二维超声及彩色多普勒超声确诊存在动脉粥样硬化斑块的患者,采用SMI技术对斑块内新生血管进行探查并分级,随后行CEUS检查,记录二者所测得的斑块内点、线状回声强度及其数量,根据相同评分标准进行对比研究。结果 25例患者中共检出35个斑块,平均厚度(3.18±0.75)cm,部位:颈总动脉杈20个,颈总动脉中段10个,颈内动脉5个;斑块回声:低回声7个,等回声18个,不均质回声6个,混合回声4个。SMI及CEUS评价斑块内强回声的分级情况的差异无统计学意义(χ2=5.35,P>0.05)。结论 SMI可以观察斑块内新生血管,为诊断斑块内是否存在新生血管提供了新的、无创诊断方法。

Objective To explore the feasibility of superb microvascular imaging （SMI） in the detection of neovascular of the plaque in carotid artery. Methods A total of 25 patients with atherosclerotic plaques diagnosed by conventional two-di- mensional ultrasound and CDFI were chosen and underwent SMI and CEUS to evaluate the plaque neovascularization and graded. The intensity and quantity of point, linear echo in plaque were measured and recorded by both of SMI and CEUS according to the same standard, and the difference were compared between SMI and CEUS. Results Standard carotid US displayed 35 plaques in 25 patients, mean thickness （3. 18 i 0. 75）cm, i.e. 20 were in bifurcation of common Carotid artery, 10 were in middle of common carotid artery, 5 were in internal carotid artery, and 7 were hypoechoic plaques, 18 were isoechoic plaques, 6 were heterogeneous echo plaques, 4 were hybrid echo plaques. The difference of the classification of eehogenic plaques between SMI and CEUS was not statistically significant （X2 = 5.35, P〈0. 05）. Conclusion SMI provides a new, non-invasive diagnostic method for diagnosing the neovascular within the plaque.