颈动脉斑块超声血管造影分级与病理微血管密度的相关性

Correlation between contrast-enhanced ultrasound grading of carotid atherosclerotic plaque and microvessel density densityon pathology

目的 探索超声血管造影(CEUS)检测到的颈动脉粥样硬化斑块内新生血管是否与斑块病理检测的微血管存在相关性。方法 前瞻性入组行颈动脉内膜剥脱术(CEA)的20例患者,所有患者术前行CEUS检查,并按照检测到的斑块内增强情况分为0~3级,术后对患者斑块标本行常规HE染色及CD31单克隆抗体标记的免疫组化染色,并根据CD31标记的斑块内微血管计算微血管密度(MVD),通过相关性分析检验CEUS分级与MVD的相关性。结果 20例患者的平均年龄为(64.9±7.1)岁,其中高血压病史13例(85%),糖尿病病史5例(25%),脑梗死病史17例(85%),冠心病病史3例(15%),外周血管病病史8例(40%),吸烟病史5例(25%),长期饮酒史2例(10%)。CEUS成像检测了20个目标斑块,按照0~3级的分级标准,其中1级2个(10%),2级7个(35%),3级11个(55%)。CD31免疫组化染色200倍高倍镜下MVD为(9.37±3.56)条/mm;。Spearman相关性分析显示CEUS新生血管分级与MVD呈正相关相关(r=0.662,P=0.001)。结论 颈动脉粥样硬化斑块CEUS的增强分级与斑块内新生血管密度密切相关。

Objective Exploring whether neovascularisation within carotid atherosclerotic plaques detected by ultrasound angiography(CEUS) correlates with microvessels detected by plaque pathology. Methods For the enrolled patients undergoing CEA surgery, all patients underwent CEUS examination before surgery, and were classified into 0-3 grades according to the detected intraplaque enhancement. After surgery, routine HE staining was performed on the plaque samples of patients, and CD31 markers were used to show intraplaque microvessels, and MVD was calculated. The correlation between CEUS grade and MVD was established by correlation analysis. Results We enrolled 20 patients with an average age of(64.9±7.1) years, including 13 patients(85%) with hypertension, 5 patients(25%) with diabetes, 8 patients(40%) with cerebral infarction, 3 patients(15%) with coronary heart disease, 8 patients(40%) with peripheral vascular disease, 5 patients(25%) with smoking, and 2 patients(10%) with long-term drinking history. CEUS imaging detected 20 target plaques on a scale of 0-3, including 2 in grade 1(10%), 7 in grade 2(35%), and 11 in grade 3(55%). The MVD value of CD31 immunohistochemical staining was(9.37±3.56)/mm;at 200 times high magnification. Spearman correlation analysis showed that CEUS neovascularization grade was positively correlated with MVD(r=0.662, P=0.001). Conclusion CEUS enhancement grade is closely related to intraplaque microvessel density.