颈动脉粥样硬化斑块患者的新生血管超声造影特点分析

Characteristics of contrast enhanced ultrasound angiography in patients with carotid atherosclerotic plaque

目的探讨颈动脉粥样硬化斑块患者的新生血管超声造影特点。方法回顾性分析本院2014年12月2016年10月收治的77例颈动脉粥样硬化斑块患者的临床资料,均实施超声造影检查。其中低回声斑组21例,等回声斑组20例,高回声斑组4例,混合回声斑组32例。结果 77例颈动脉粥样硬化斑块中有61例出现不同程度的新生血管强化现象,强化阳性率为79.22%(61/77),颈动脉粥样硬化斑块分级Ⅲ级占大多数(32.47%)。低回声斑组与混合回声斑组比较、等回声斑组和高回声斑组比较差异均无统计学意义(P>0.05);低回声斑与混合回声斑的AUC与PI统计结果均显著高于等回声斑和高回声斑,RT均显著低于等回声斑和高回声斑(均P<0.05)。造影强化程度分级越高,相应的斑块病理组织学新生血管形成数量越多,二者之间存在明显的正相关(r=0.857,P<0.05);PI越高,相应的斑块病理组织学新生血管形成数量也越多,二者之间存在明显正相关(r=0.913,P<0.05)。结论对颈动脉粥样硬化斑块患者实施超声造影检查,可以较好地掌握斑块内新生血管的特征,以更好地评估斑块易损性。

Objective To explore the characteristics of contrast enhanced ultrasound angiography in patients with carotid atherosclerotic plaque. Methods The clinical data of 77 patients with carotid atherosclerotic plaques admitted in our hospital from December 2014 to 2016 in were analyzed retrospectively.There were 21 cases of low echo plaque,20 cases of echo plaque,4 cases of echo plaque group,32 cases of mixed echo plaque group. Results In 77 cases of carotid atherosclerosis plaques,61 cases had different degree of neovascularization enhancement,the positive rate was 79. 22%（ 61/77）,and the majority of carotid atherosclerotic plaques were grade Ⅲ（ 32. 47%）. Low echo plaque group and mixed echo spot groups,such as echo plaque group and high echo spot groups showed no significant difference（ P 0. 05）; AUC and PI statistical results of hypoechoic plaques and mixed plaques were significantly higher than that of other echo echo spots and hyperechoic spots,RT were significantly lower than that of echospots and high echo spots（ P〈 0. 05）. The higher the degree of contrast enhancement,corresponding to the formation of new vascular plaques were more,there was a positive correlation between the two（ r =0. 857,P 〈0. 05）; the higher the PI,the plaque formation of the corresponding number of freshmen were more,there was a positive correlation between the two（ r = 0. 913,P 〈0. 05）. Conclusion Contrast enhanced ultrasound examination of carotid atherosclerotic plaque patients can better grasp the characteristics of plaque neovascularization,in order to better assess the vulnerability of plaque.