超微血流成像技术在颈动脉易损斑块诊断中的应用价值

Value of Superb Micro-vascular Imaging in Diagnosing Carotid Artery Vulnerable Plaque

目的探讨超微血流成像技术(SMI)对颈动脉易损斑块的诊断价值。方法对本院69例患者108处常规超声检查发现颈动脉低回声或低回声为主混合回声斑块,均行SMI及超声造影(CEUS)检查,按照CEUS及SMI评分标准(0、1、2分),评价SMI与CEUS检出斑块内新生血管的一致性。结果 SMI较常规超声能清楚显示斑块轮廓及形态。SMI显示75处斑块内有新生血管,CEUS显示76处斑块内有新生血管,SMI与CEUS对斑块内新生血管评分一致数共计90处,两种评分结果高度一致(Kappa值=0.748)。SMI检查结果显示溃疡斑6处,同样,CUES检查结果显示溃疡斑6处,两种检查结果完全一致。108处斑块中有55处造成管腔狭窄,SMI显示斑块内有无新生血管与斑块是否造成管腔狭窄无关(P=0.473)。结论 SMI能清楚显示颈动脉斑块轮廓、形态及斑块内新生血管,可评估斑块的易损性。

Objective To explore the diagnostic value of superb micro-vascular imaging(SMI)for patients with vulnerable plaque of carotid artery.Methods Totally 69 patient with carotid hypoechoic or predominantly hypoechoic plaque(108 plaques),which were identified by conventional ultrasound,underwent SMI and contrast-enhanced ultrasound(CEUS).Based on the scores of CEUS and SMI(0,1,and 2 points),the consistency of SMI and CEUS in detecting plaque neovascularization was assessed.Results SMI could more clearly display the profile and morphology of the plaques than conventional ultrasound.SMI showed that there were neovascularization in 75 plaques,and CEUS showed that there were neovascularization in 76 plaques;the number of scoring consistency in the plaque neovascularization under SMI and CEUS was 90,suggesting these two results were highly consistent(Kappa value=0.748).There were 6 ulcerated carotid plaques detected by SMI,and the same 6 ulcerated carotid plaques were detected by CEUS,showing complete consistency.Of these 108 plaques,55 caused stenosis of the lumen,and SMI showed there was no correlation between plaque neovascularization and stenosis of the lumen caused by plaques(P=0.473).Conclusions SMI can clearly display the morphology and outline of the plaques and the plaque neovascularization.Therefore,it can be used for evaluating plaque vulnerability.