超声造影评估颈动脉斑块易损性预测脑梗死复发的价值研究

Evaluation of carotid plaque vulnerability by contrast-enhanced ultrasonography in predicting recurrence of cerebral infarction

目的探讨超声造影评估颈动脉斑块易损性预测脑梗死复发的价值.方法选择68例初发脑梗死患者,均行常规超声和超声造影检查评估颈动脉斑块易损性,观察患者1年内复发情况,比较常规超声和超声造影在脑梗死复发预测中的价值.结果68例患者颈动脉斑块109块,1年后复发25例,斑块数39块;复发组和未复发组颈动脉斑块回声分级、新生血管分级比较,差异均有统计学意义(Z分别=8.95、19.69,P均<0.05);以新生血管分级>Ⅲ级、新生血管>Ⅱ级、新生血管分级>Ⅰ级、回声分级<Ⅲ级、回声分级<Ⅱ级为标准预测脑梗死复发的ROC曲线下面积(AUC)分别为0.60、0.74、0.61、0.63、0.62.结论超声造影评估颈动脉斑块易损性是预测脑梗死复发的有效指标.

Objective To explore the value of contrast-enhanced ultrasonography for evaluating the vulnerability of carotid plaque in predicting the recurrence of cerebral infarction. Methods A total of 68 patients with initial cerebral infarction were selected,carotid artery plaque of these patients were assessed to evaluate two-dimensional echo grading by conventional ultrasound and angiogenesis grading by contrast-enhanced ultrasound respectively.The recurrence of cerebral infarction within one year was followed up and the predictive value of two-dimensional echo grading and neovascularization grading was compared. Results There were 109 carotid plaques in 68 patients with cerebral infarction,25 cases recurred within 1 year with 39 patches.The echo grading and neovascularization grading of carotid artery plaque between the two groups were significantly different(Z=8.95,19.69,P<0.05).According to the criteria of neovascularization grade>Ⅲ,neovascularization grade>Ⅱ,neovascularization grade>Ⅰ,echo grade<Ⅲ,and echo grade<Ⅱ,the AUC for predicting cerebral infarction recurrence were 0.60,0.74,0.61,0.63 and 0.62,respectively.Conclusion Evaluation of carotid plaque vulnerability by contrast-enhanced ultrasound is an effective indicator for predicting recurrence of cerebral infarction.