超声造影评估脑梗死患者颈动脉斑块晚期增强的价值

The value of late-phase enhancement of carotid artery plaques in patients with cerebral infarction by contrast-enhanced ultrasonography

目的探讨超声造影评估脑梗死患者颈动脉斑块晚期增强的价值。方法收集2013年4月至7月浙江省人民医院收治的有颈动脉斑块且双侧颈动脉最大斑块厚度均>1.5 mm的患者68例。其中非脑梗死组患者18例,脑梗死组患者50例,包括单侧脑梗死患者30例,双侧脑梗死患者20例。对所有患者双侧颈动脉最大斑块进行常规超声和超声造影检查,于造影剂注入后6 min进行时间-强度曲线分析,测量并计算颈动脉斑块晚期增强强度、增强相对强度。采用两样本t检验分别比较脑梗死组与非脑梗死组患者、脑梗死组患者梗死侧与非梗死侧颈动脉斑块晚期增强强度、增强相对强度差异。结果脑梗死组患者、非脑梗死组患者颈动脉斑块晚期增强强度分别为(6.0±1.5)、(4.9±1.2)d B,增强相对强度分别为0.9±0.4、0.8±0.2,脑梗死组患者颈动脉斑块晚期增强强度、增强相对强度均高于非脑梗死组患者,且差异均有统计学意义(t值分别为2.132、2.258,P值均<0.05)。脑梗死组患者梗死侧、非梗死侧颈动脉斑块晚期增强强度分别为(7.1±1.8)、(4.9±1.2)d B,增强相对强度分别为1.2±0.3、0.8±0.2,脑梗死组患者梗死侧颈动脉斑块晚期增强强度、增强相对强度均高于非梗死侧,且差异均有统计学意义(t值分别为3.132、2.953,P值均<0.01)。结论脑梗死患者颈动脉斑块晚期增强特点与非脑梗死患者差异明显。

Objective To evaluate the late-phase enhancement of carotid artery in patients with cerebral infarction by contrast-enhanced ultrasonography. Methods Sixty-eight patients whose bilateral carotid artery plaques were both wider than 1.5 mm with treatment in Zhejiang Provincial People？s Hospital from April to July in 2013 were enrolled in this study. Among the enrolled patients, there are 50 patients with cerebral infarction including 30 patients with unilateral cerebral infarction and 20 patients with bilateral cerebral infarction, and 18 patients without cerebral infarction. The enrolled patients underwent conventional and contrast-enhanced ultrasonography. The time-intension curve was obtained till 6 minutes after the injection of contrast agent. The late-phase enhancement intensity and relative intensity of maximal carotid plaque was measured and calculated. The differences of late-phase enhancement intensity and relative intensity between patients with cerebral infarction and patients without cerebral infarction, and between ipsilateral and contralateral side of cerebral infarction in patients with cerebral infarction were compared using two sample t test. Results The late-phase enhancement intensity of carotid plaque in patients with cerebral infarction and in patients without cerebral infarction was（6.0±1.5） and（4.9±1.2） d B, respectively, and the relative late-phase enhancement intensity of carotid plaque was 0.9±0.2 and 0.8±0.2, respectively. The late-phase enhancement intensity and the relative intensity of carotid plaque was higher in patients with cerebral infarction compared with patients without cerebral infarction, and the differences had statistical significance（value of t was 2.132 and 2.258 respectively, value of P were both less than 0.05）. The late-phase enhancement intensity of carotid plaque in ipsilateral and contralateral side of cerebral infarction was（7.1±1.8） and（4.9±1.2） d B, respectively, and the relative late-phase enhancement intensity of carotid plaque was 1.2±0.3 and 0.8±0.2, respectively. The late-phase enhancement intensity and the relative intensity of carotid plaque was higher in ipsilateral side of cerebral infarction compared with contralateral side of cerebral infarction in patients with cerebral infarction, and the differences had statistical significance（value of t was 3.132 and 2.953 respectively, value of P were both less than 0.01）. Conclusion The late-phase enhancement of carotid plaque in patients with cerebral infarction is significantly different from that in patients without cerebral infarction.