超声造影时间-强度曲线评价颈动脉硬化疾病的诊断价值

Diagnostic value of carotid atherosclerosis using time-intensity curve

目的探讨超声造影在颈动脉硬化疾病中应用的可行性,应用超声造影时间-强度曲线(TIC)分析颈动脉管腔内超声造影剂微泡灌注特征。方法对21例患者的21支颈动脉行超声造影检查,观察颈动脉管腔超声造影剂充填情况。应用超声造影TIC分析颈动脉注入超声造影剂后微泡灌注特征,测量造影后最狭窄处血管近端及稍远端血管管腔内造影剂灌注出现的时间、到达峰值时间及视频强度差值。结果狭窄血管近端与稍远端造影剂微泡进入时间及增强至峰值时间比较差异均无统计学意义;狭窄血管近端与稍远端视频强度差值分别为(30.54±4.84)d B,(13.54±2.84)d B,差异有统计学意义(P<0.05)。结论超声造影检查可应用于颈动脉硬化疾病中,同时应用超声造影TIC可定量观察颈动脉管腔内造影剂微泡灌注特征。

Objective To investigate the feasibility of intravenous contrast enhanced ultrasound（CEUS）in the diagnosis of carotid atherosclerosis,and evaluate the characteristics of the microbubble contrast perfusion using time-intensity curve.Methods Twenty-one patients with carotid artery atherosclerosis were investigated using CEUS.The time-intensity curve of each patient was analyzed.Parameters of the time-intensity curve including arrival time to enhancement（ET）,time to peak intensity（PIT）,and dispatch peak signal intensity were measured using low mechanical index contrast gray scale imaging.Results There were no difference of parameters in ET and PIT after contrast agent injection between the proximal and distal part of the stenosis zone,however,the difference of the dispatch peak signal intensity in the proximal and distal part of the stenosis zone was significant[（30.54±4.84）d B vs.（13.54±2.84）d B,P0.05].Conclusion CEUS is an effective and noninvasive procedure to detect stenosis or occlusion for the carotid arteries.