超声造影评价颈动脉粥样硬化斑块新生血管与脑梗死相关性研究

Study on the correlation between neovascularization in carotid atherosclerotic plaque and cerebral infarction assessed by contrast-enhanced ultrasonography

目的 研究超声造影评价颈动脉粥样硬化(CAS)斑块新生血管与脑梗死的相关性。方法 选择2013年1月-2019年12月本院收治的100例住院脑梗死患者和同期100名正常人群体检者作为研究对象,将其分为脑梗死组(脑梗死患者)和对照组(正常人群体检者)两组。比较两组患者斑块类型分布情况、造影剂到达时间(AT)、达峰时间(TTP)、斑块的基础强度(BI)、峰值强度(PI)、增强强度(IE)、增强密度(DE),对差异具有统计学意义指标,采用Spearman分析相关性。结果 脑梗死组患者总斑块数(119个)多于对照组(18个),且脑梗死组患者易损斑块和稳定斑块高于对照组,差异有统计学意义(P<0.05);两组患者AT比较差异无统计学意义(P>0.05);脑梗死组患者TTP短于对照组,而BI、PI、IE、DE高于对照组,差异有统计学意义(P<0.05);TTP较早、高IE、高DE均与脑梗死的发生呈正相关(P<0.05)。结论 超声造影可评估颈动脉粥样硬化斑块的性质,并直观显示斑块内新生血管的存在与分布状况,同时TTP较早、高IE、高DE均与脑梗死的发生呈正相关,对三指标进行量化分析可无创性预测脑梗死的发生风险,为临床预防性干预提供参考,以最大程度改善患者的预后。

Objective To evaluate the correlation between carotid atherosclerosis(CAS) plaque neovascularization and cerebral infarction by contrast-enhanced ultrasonography.Methods One hundred patients suffered with cerebral infarction admitted to our hospital from January 2013 to December 2019 were enrolled as cerebral infarction group. 100 normal people underwent physical examination in our hospital during the same period were selected as the control group. The distribution of plaque type and the arrival time(AT) of contrast agent, time to peak(TTP), basal intensity(BI), peak intensity(PI), enhanced intensity(IE), enhanced density(DE) of the plaque were compared.The indicators with statistically significant differences were used for correlation analysis by using Spearman analysis method.Results The total number of plaques in the cerebral infarction group(119) was higher than that in the control group(18), and the proportion of vulnerable plaque and stable plaque in the cerebral infarction group were higher than that of the control group, the difference was statistically significant(P<0.05). There was no significant difference in the AT between the two groups(P>0.05). The TTP of the cerebral infarction group was shorter than that of the control group, and the BI, PI, IE, and DE were higher than those of the control group(P<0.05). The earlier TTP, high IE and High DE were positively correlated with the occurrence of cerebral infarction(P<0.05).Conclusions Contrast-enhanced ultrasonography could evaluate the nature of carotid atherosclerotic plaque and visually show the presence and distribution of neovascularization in plaque. At the same time, earlier TTP, high IE and high DE are positively correlated with the occurrence of cerebral infarction. Quantitative analysis of the three indicators could non-invasively predict the risk of cerebral infarction and provide a reference for clinical preventive intervention to maximize the prognosis of patients.