超声造影评估脑梗死患者颈动脉滋养血管新生的特点

Evaluation on characteristics of vasa vasorum angiogenesis of carotid artery 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滋养血管新生的特点。方法对47例脑梗死患者(脑梗死组)和18例非脑梗死患者(非脑梗死组)行双侧颈动脉超声造影检查,对颈动脉滋养血管进行分级,绘制受试者工作特征曲线分析颈动脉滋养血管分级判断脑梗死的敏感性、特异性及曲线下面积;评估观察者之间确定颈动脉滋养血管分级的一致性。结果脑梗死组梗死侧颈动脉滋养血管以Ⅰ级为主,与脑梗死组非梗死侧和非脑梗死组双侧颈动脉滋养血管分级比较差异均有统计学意义(P=0.0104、0.0005、0.0085)。Ⅰ级滋养血管中脑梗死的比例明显高于0级滋养血管者,差异有统计学意义(P=0.0001);以颈动脉滋养血管Ⅰ级为标准评价脑梗死的敏感性、特异性及曲线下面积分别为72.3%、61.5%及0.669;观察者间评估颈动脉滋养血管新生的一致性均较佳。结论脑梗死与非脑梗死的颈动脉滋养血管分级差异明显,颈动脉滋养血管分级是预测脑梗死的一个有效指标,且观察者间一致性佳。

Objective To explore the characteristics of vasa vasorum angiogenesis of carotid artery in patients with cerebral infarction evaluated by contrast-enhanced ultrasonography(CEUS).Methods Forty-seven patients with cerebral infarction and18controls were studied by CEUS.The grade of vasa vasorum angiogenesis of carotid artery was analyzed.The sensitivity,specificity and area under curve(AUC)of the grade of vasa vasorum angiogenesis of carotid artery in diagnosis of cerebral infarction were analyzed by ROC.The consistency of the grade of vasa vasorum angiogenesis of carotid artery between subjects was analyzed.Results Vasa vasorum angiogenesis of carotid artery on the side of infarction in patients with cerebral infarction were almost gradeⅠ,there were significant differences of the grade of vasa vasorum angiogenesis of carotid artery compared with the side without infarction in patients with cerebral infarction and the controls(P=0.0104,0.0005,0.0085).The ratio of cerebral infarction in the gradeⅠwas significantly higher than that in the grade0(P=0.0001).The sensitivity,specificity and AUC of gradeⅠof vasa vasorum angiogenesis of carotid artery in evaluating cerebral infarction were72.3%,61.5%,0.669,respectively.Interobserver consistency was pretty good.Conclusion There are significant differences of the grade of vasa vasorum angiogenesis of carotid artery between patients with cerebral infarction and without cerebral infarction,and the grade of vasa vasorum angiogenesis of carotid artery is a valid indicator to predict cerebral infarction which has good consistency.