对比超声增强评估颈动脉低回声斑块增强强度与前循环脑梗死的关系

Correlation between intraplaque neovacularization of carotid low-echo plaque with brain infarction in antertior cycle by contrast-enhanced ultrasound

目的运用对比超声增强技术(contrast-enhanced ultrasound,CEUS)评估颈动脉低回声斑块新生血管强化分级与急性前循环责任病灶侧脑梗死的关系。方法对60例急性前循环脑梗死患者双侧颈动脉低回声斑块行CEUS,根据斑块造影增强程度分为Ⅰ~Ⅳ级,并检测所有斑块的厚度。结果与非责任病灶侧相比,前循环责任病灶侧脑梗死检出低回声斑块53例(88.3%),经CEUS检测,责任病灶侧低回声斑块Ⅲ级增强患者比率明显高于Ⅰ级和Ⅱ级(χ~2分别为5.588,3.565,P<0.05),但与Ⅳ级比较差异无统计学意义(χ~2=0.005,P=0.944),责任病灶侧Ⅲ级与Ⅳ级发生率明显高于非责任病灶侧(χ~2=8.394,P=0.004)。颈动脉低回声斑块厚度与斑块内新生血管强化程度之间存在正相关关系(r=0.599,P<0.001)。结论前循环脑梗死的发生与病灶侧颈动脉低回声斑块新生血管强化程度有关,Ⅲ、Ⅳ级增强者斑块更易损,并随着斑块厚度的增加,斑块强化程度增加。颈动脉低回声斑块新生血管强化程度对急性前循环脑梗死发生预测有一定意义。

Objective To evaluate the correlation between the degree of enhancement in intraplaque neovacularization of carotid lowecho plaque with the lesion side of acute brain infarCTion in antertior cycle by contrast-enhanced ultrasound（ CEUS）. Methods Contrast-enhanced ultrasound ultra sound was performed on both of carotid low-echo plaque of 60 patients of acute brain infarCTion. According to contrast-enhancement degree,they were assigned into grade Ⅰ to Ⅳ,and the thickness of all of plaque were deteCTed. Results Compared with the non-responsible lesion side,53 cases（ 88. 3%） of low-echo plaques were deteCTed in the lateral cerebral infarCTion of the anterior circulation responsibility lesion. The CEUS imaging revealed the proportions of grade Ⅲ of low-echo plaques in the lesion side were significantly higher than grade Ⅰ and Ⅱ（ χ~2= 5. 588,3. 565,P〈0. 05）. However,there was no statistically significant difference compared with grade Ⅳ（ χ~2= 0. 005,P = 0. 944）. Compared with the non-responsible lesion side,the incidence of the gradeⅢ and Ⅳ were significantly higher（ χ~2= 8. 394,P = 0. 004） in lesion side. The thickness of low-echo plaques was correlated with the enhanced intensity of ultrasonography（ r = 0. 599,P〈0. 001）. Conclusions The occurrence of anterior circulation cerebral infarCTion was correlated with degree of enhancement in intra-plaque neovascularization in the carotid artery,the grade Ⅲ and grade Ⅳ of lowecho plaques were more vulnerable,and the degree of enhancement in plaque increases with the increasing of plaque thickness. The degree of enhancement in intra-plaque neovacularization of low-echo plaques of carotid has a certain significance in prediCTing the occurrence of acute anterior circulation cerebral infarCTion.