应用超微血管成像技术诊断颈动脉斑块新生血管的临床研究

Clinical study on carotid plaque neovascularization detected using superb microvascular imaging

目的评价超微血管成像技术用于诊断颈动脉斑块新生血管情况及稳定性的临床价值。方法选取2018年6月至2020年6月于温州市第七人民医院就诊的72例颈动脉粥样硬化斑块患者为研究对象,并经手术取出颈动脉斑块100处,于颈动脉斑块取出术前分别进行超微血管成像和超声造影检查,并以斑块病理检查结果为金标准,评估不同检查方法对颈动脉斑块新生血管和稳定性的诊断效能,统计不同检查方法诊断结果与金标准的一致性。结果超微血管成像检查对于颈动脉斑块新生血管情况的诊断灵敏度、特异度和准确度分别为93.24%、92.31%和93.00%,超声造影检查分别为95.96%、96.15%和96.00%,超微血管成像检查和超声造影检查对颈动脉斑块新生血管情况的诊断结果与斑块组织病理检查的Kappa值分别为0.825和0.923。超微血管成像检查对于颈动脉斑块稳定性的诊断灵敏度、特异度和准确度分别为94.74%、95.35%和95.00%,超声造影检查分别为96.49%、97.67%和97.00%;超微血管成像检查与超声造影检查对颈动脉斑块稳定性情况的诊断结果与斑块组织病理检查的Kappa值分别为0.898、0.939。结论超微血管成像对颈动脉斑块新生血管和稳定性的诊断效能与超声造影检查相当,具有无创、操作简便等优势,值得临床推广使用。

Objective To evaluate carotid plaque neovascularization and vessel stability using superb microvascular imaging.Methods Seventy-two patients with carotid atherosclerotic plaques received treatment in The Seventh People's Hospital of Wenzhou from June 2018 to June 2020 and were included in this study.A total of 100 carotid plaques were surgically removed from these patients.These patients were subject to superb microvascular imaging and contrast-enhanced ultrasonography before carotid plaques were removed.Taking pathological results of carotid plaque as a gold standard,we investigated the efficacy of superb microvascular imaging versus contrast-enhanced ultrasonography in detecting carotid plaque neovascularization and vessel stability and evaluated the detection consistency of each imaging method with the gold standard.Results The sensitivity,specificity,and accuracy of superb microvascular imaging in detecting carotid plaque neovascularization were 93.24%,92.31%,and 93.00%,and they were 95.96%,96.15%,and 96.00%for contrast-enhanced ultrasonography.The Kappa values of consistency of agreement on carotid plaque neovascularization identification were 0.825 and 0.923 for superb microvascular imaging and contrast-enhanced ultrasonography,respectively.The sensitivity,specificity,and accuracy of superb microvascular imaging in detecting vessel stability were 94.74%,95.35%,and 95.00%,respectively and they were 96.49%,97.67%,and 97.00%,respectively for contrast-enhanced ultrasonography.The Kappa values of consistency of agreement on vessel stability evaluation were 0.898 and 0.939 for superb microvascular imaging and contrast-enhanced ultrasonography,respectively.Conclusion Superb microvascular imaging has equivalent efficacy in detecting carotid plaque neovascularization and vessel stability to contrast-enhanced ultrasonography.Superb microvascular imaging is non-invasive,provides ease in operation,and is worthy of clinical promotion.