颈动脉斑块微钙化负荷及易损性评分与PET-CT检查中^(18)F-氟化钠吸收率的相关性分析

Correlations of micro-calcification load in carotid plaques and plaque vulnerability scores with 18F-sodium fluoride uptake ratio in PET-CT

目的研究Micropure^(®)超声技术下颈动脉斑块微钙化负荷及斑块易损性评分与PET-CT检查中^(18)F-氟化钠(^(18)F-NaF)吸收率[即组织-背景比值(TBR)]的关系。方法收集苏州大学附属第三医院(常州市第-.人民医院)神经内科自2017年3月至2020年11月收治的颈动脉粥样硬化斑块患者资料,将患者中经Micropure^(®)技术和^(I8)F-NaFPET-CT检测均提示存在斑块微钙化的颈动脉纳入研究。以Micropure^(®)超声技术检测中颈动脉斑块中显示的荧光斑点数量为斑块微钙化负荷(负荷数≥5为大量微钙化组,负荷数<5为少量微钙化组),依据《颈动脉粥样硬化评分与缺血性卒中的诊断》中颈动脉斑块评分方法进行斑块易损性评分,分析39条颈动脉的微钙化负荷及易损性评分与TBR值的相关性。结果共28例患者39条颈动脉纳入研究,其中24条颈动脉归为大量微钙化组,15条颈动脉归为少量微钙化组;大量微钙化组TBR值为2.61±0.73,少量微钙化组TBR值为1.93±0.43.差异有统计学意义(t=-3.657,P=0.001)。39条颈动脉微钙化负荷为5(3,5),与TBR值(2.35±0.71)呈正相关关系(r_(s)=0.519,P=0.001);39条颈动脉斑块易损性评分为2(2,3),与TBR值无相关性(r_(s)=0.086,P=0.602)。结论Micropure^(®)技术检测的颈动脉斑块微钙化负荷与18F-NaF吸收率相关,斑块微钙化负荷越大18F-NaF吸收越明显。

Objective To explore the correlations of micro-calcification load in carotid plaques and plaque vulnerability scores detected by Micropure^(®)ultrasonic technology with 18F-sodium fluoride(^(18)F-NaF)uptake ratio(tissue-background ratio[TBR])in positron emission tomography-computed tomography(PET-CT).Methods Baseline data of patients with carotid atherosclerotic plaques admitted to our hospital from March 2017 to November 2020 were collected.Carotid arteries of these patients simultaneously positive on Micropure^(®)ultrasound examination and ^(18)F-NaF PET-CT were included.The number of spots in carotid plaques detected by Micropure^(®)ultrasonic technology was defined as load of micro-calcification:they were divided into large number of micro-calcifications group(≥5 spots)and small number of micro-calcifications group(1-4 spots).The scores of carotid plaque vulnerability were evaluated according to carotid atherosclerosis scores in Diagnostic Value of Carotid Atherosclerosis Score for Ischemic Stroke.Correlations of TBR with micro-calcification load and plaque vulnerability scores in these 39 carotid arteries were analyzed.Results Thirty-nine carotid arteries from 28 patients were enrolled:24 carotid arteries were classified into the large number of micro-calcifications group and 15 carotid arteries were classified into the small number of micro-calcifications group.TBR of the large number of micro-calcifications group(2.61±0.73)was significantly increased as cpmpared with that of the small number of micro-calcifications group(1.93±0.43,t=-3.657,P=0.001).In the 39 carotid arteries,micro-calcification load was 5(3,5),while the carotid plaque vulnerability scores were 2(2,3);micro-calcification load was positively correlated with TBR(2.35±0.71,rs=0.519,P=0.001),but no correlation was noted between TBR and carotid plaque vulnerability scores(r_(s)=0.086,P=0.602).Conclusion Carotid plaque micro-calcification load detected by Micropure^(®)ultrasound examittation is associated with 18F-NaF uptake ratio;the larger the micro-calcification load,the more obvious the uptake of 18F-NaF.