超声检查在颈动脉斑块角度测量中的应用价值及其与新生血管的相关性研究

Application of ultrasonography in the measurement of carotid artery plaque angle and its correlation with neovascularization

目的探讨超声检查在颈动脉斑块角度测量中的应用价值及其与新生血管的相关性。方法选择2019年4月至2023年4月颈动脉粥样软斑块导致血管狭窄患者148例作为对象,根据患者疾病类型分为脑梗死组(n=63例)和非脑梗死组(n=85例)。2组均完成超声检查,借助线阵探头对颈动脉斑块角度、软斑块厚度、颈动脉面积狭窄率进行计算;2组患者均行颈动脉斑块剥脱术治疗,采用超声造影检查2组新生血管检出率;采用Pearson相关性分析软件对颈动脉斑块角度与新生血管进行相关性分析。结果脑梗死组与非脑梗死组斑块厚度、斑块面积差异均无统计意义(P>0.05);脑梗死组斑块近心端角度大于非脑梗死组(P<0.05);2组均经超声造影完成新生血管检出率测定,其中,脑梗死患者新生血管检出46例,占比为73.02%,高于非脑梗死组(新生血管检出22例,检出率为25.88%)(P<0.05);Pearson相关性结果表明,颈动脉粥样软斑块患者中新生血管检出率与斑块厚度、斑块面积无相关性(P>0.05);与斑块近心端角度呈正相关(P<0.05)。结论超声检查用于颈动脉粥样软斑块患者中能准确地测量斑块的角度、厚度,且与新生血管存在强相关性,通过超声能更好地理解颈动脉斑块的生物行为,为预防脑卒中和指导临床治疗提供科学依据,直观预测评估斑块的易损性,是影像学评估和管理预防脑卒中的无损伤手段。

Objective To investigate the application of ultrasonography in the measurement of carotid artery plaque angle and its correlation with neovascularization,improve the prediction accuracy of stroke risk in patients with carotid artery stenosis(CAS),and provide scientific basis for the personalized treatment.Methods A total of 148 patients with carotid atherosclerotic soft plaques admitted from April 2019 to April 2023 were selected as the subjects.They were divided into cerebral infarction group(n=63)and non-cerebral infarction group(n=85)according to their disease types.Ultrasonography was performed in patients of both groups.Carotid artery plaque angle,soft plaque thickness and carotid artery area stenosis rate were calculated with linear array probe.Carotid artery plaque removal was performed in both groups.The detection rate of neovascularization in both groups was examined by contrast-enhanced ultrasound.Pearson correlation analysis was used to analyze the correlation between carotid artery plaque angle and neovascularization.Results There were no significant differences in plaque thickness and plaque area between cerebral infarction group and non-cerebral infarction group(P>0.05).The proximal plaque angle in cerebral infarction group was significantly greater than that of non-cerebral infarction group(P<0.05).The detection rate of neovascularization was measured by contrast-enhanced ultrasound in both groups.The results showed that 46 and 22 cases of neovascularization were detected in patients with cerebral infarction and non-cerebral infarction group,respectively.The detection rate of neovascularization was significantly higher in the cerebral infarction group than that of non-cerebral infarction group(73.02%vs 25.88%,P<0.05).Pearson correlation results showed that the detection rate of neovascularization in patients with carotid atherosclerotic soft plaque was not correlated with plaque thickness and plaque area(P>0.05),but positively correlated with the angle of the plaque at proximal end(P<0.05).Conclusion Ultrasonography in patients with carotid atherosclerotic soft plaque can accurately measure the angle and thickness of plaque,and there is a strong correlation with neovascularization.Through it,we can better understand the biological behavior of plaques and provide scientific basis for the prevention and clinical treatment of stroke.Ultrasonography can predict and evaluate the vulnerability of plaque,worthy of clinical treatment.