颈动脉斑块超声造影联合ABCD评分与急性脑梗死体积关系分析

Analysis of the relationship between the carotid artery plaque contrast-enhanced ultrasound combined with ABCD score and the volume of acute cerebral infarction

目的:探讨颈动脉斑块超声造影联合年龄、血压、临床特征、症状持续时间(ABCD)评分与急性脑梗死体积关系。方法:选择医院收治的100例急性脑梗死患者,根据磁共振成像(MRI)脑梗死灶体积将其分为小体积组(28例,梗死灶最大体积<5 cm^(3))、中体积组(42例,梗死灶最大体积5~10 cm^(3))及大体积组(30例,梗死灶最大体积>10 cm^(3))。应用彩色多普勒超声诊断仪检查,记录斑块最大厚度;通过斑块造影增强的时间-信号强度曲线获得斑块造影峰值强度(PI);进行ABCD2(增加病史)评分和ABCD3(增加病史、脑缺血及颈动脉狭窄)评分。结果:大体积组斑块厚度和PI高于中体积组和小体积组,中体积组斑块厚度和PI高于小体积组,3组斑块厚度和PI比较差异有统计学意义(F=49.770,F=100.566;P<0.05)。大体积组ABCD2评分和ABCD3评分高于中体积组和小体积组,且中体积组ABCD2评分和ABCD3评分高于小体积组,3组两项评分比较差异均有统计学意义(F=80.494,F=158.830;P<0.05)。斑块厚度、PI、ABCD2评分和ABCD3评分与脑梗死灶大体积呈线性正相关。结论:颈动脉斑块超声造影评价斑块厚度和PI及ABCD2评分和ABCD3评分与急性脑梗死体积呈线性正相关。

Objective:To investigate the relationship between the carotid plaque contrast-enhanced ultrasound combined with the score of age,blood pressure,clinical characteristics and duration of symptoms(ABCD)and the volume of acute cerebral infarction.Methods:A total of 100 patients with acute cerebral infarction who admitted to hospital were selected and they were divided into the small volume group(28 cases,the maximum volume of infarct lesion<5 cm^(3)),the medium volume group(42 cases,the range of the maximum volume of infarct lesion was from 5 to 10 cm^(3))and the large volume group(30 cases,the maximum volume of infarct lesion>10 cm^(3))according to the volume of cerebral infarction in MRI image.The maximum thickness of plaque was recorded by using color Doppler ultrasound diagnostic instrument.The time-signal intensity curve with plaque contrast enhancement was used to obtain the peak intensity(PI)of plaque contrast.And then,the ABCD2(add medical history)score and ABCD3(add medical history,cerebral ischemia and carotid artery stenosis)scores were performed.Results:The plaque thickness and PI of the large volume group were respectively higher than those of the medium volume group and the small volume group,and the plaque thickness and PI of the medium volume group were respectively higher than those of the small volume group,and the differences of plaque thickness and PI among the three groups respectively were significant(F=49.770,F=100.566,P<0.05).Both the ABCD2 score and the ABCD3 score of the large volume group were respectively higher than those of the medium volume group and the small volume group,and both the ABCD2 score and the ABCD3 score of the medium volume group were respectively higher than those of the small volume group,and the differences of them among the three groups respectively were significant(F=80.494,F=158.830,P<0.05).Plaque thickness,PI,ABCD2 score and ABCD3 score respectively appeared linear positive correlation with the large volume.Conclusion:The plaque thickness,PI,ABCD2 score and ABCD3 score respectively appear linear positive correlation with the volume of acute cerebral infarction as the evaluation of carotid artery plaque contrast-enhanced ultrasound.