颈动脉粥样硬化斑块溃疡的超声诊断探讨

Significance of ultrasonic diagnosis of carotid atherosclerotic plaque ulcers

目的探讨超声在诊断颈动脉粥样硬化斑块溃疡中的临床意义。方法选择2015-01—12开封市中心医院诊断的颈动脉粥样斑块患者100例。所有患者采用西门子彩色多普勒超声仪检查,观察颈动脉粥样硬化分布情况,分析超声下颈动脉粥样硬化并发溃疡的影像学特点。结果 100例患者,42例斑块位于颈动脉分叉处,占42.0%;38例位于颈内动脉,占38.0%;13例位于颈外动脉,占13.0%;7例位于颈总动脉,占7.0%。二维超声图像显示,颈动脉壁增厚,斑块贴服在内膜上,形态大多不规则,局限性或弥漫性分布。硬斑块呈强回声,软斑块呈低回声。颈动脉粥样硬化斑块伴溃疡,可见内膜回声不连续,斑块内可见低回声,提示溃疡形成,部分巨大溃疡可见斑块顶部呈"火山口"征;彩色多普勒血流图可显示血流进入溃疡斑块内部。结论超声诊断颈动脉粥样硬化具有方便、快捷、经济、无创等优点,尤其对粥样斑块合并溃疡,有典型的影像学特征,能够为临床诊断及治疗提供依据。

Objective To discuss the significance of ultrasonic diagnosis of carotid atherosclerotic plaque ulcers. Methods 100 cases with carotid atherosclerotic plaque from January to December 2015 were selected as subjects.All cases were detected by SIEMENS color Doppler ultrasound.The distribution of carotid atherosclerosis was observed and the imaging features of carotid atherosclerosis and ulceration were analyzed. Results In 100 cases,42 cases had plaque in the carotid bifurcation,accounted for 42%,38 cases in internal carotid artery,accounting for 38%,13 patients in the external carotid artery,accounting for 13%,and 7 cases in the carotid artery,accounting for 7%.Two dimensional ultrasound image showed that,the wall of the carotid artery was thickened,and the plaque was attached to the intima.Most of the plaque forms were irregular,localized or diffused.The hard plaque was strongly echoed and the soft plaque was hypoechoic.Carotid atherosclerotic plaques with ulcers showed that the internal echo of the endometrium was discontinuous,and the hypoechoic was visible in the plaque,suggesting the formation of ulcers,and some giant ulcers show the "crater" sign on the top of the plaque;Color Doppler flow imaging could show blood flow within ulcer plaque. Conclusion Ultrasound diagnosis of carotid atherosclerosis is convenient,fast,economic,non invasive and have other advantages,especially for atheromatous plaque with ulcersor,typical imaging features.It can provide evidence for clinical diagnosis and treatment.