彩色多普勒超声联合超微血流技术评估颈动脉斑块特征及稳定性的价值

Value of color Doppler flow imaging combined with superb microvascular imaging on evaluating the characteristics and stability of carotid plaque

目的探究彩色多普勒超声(CDFI)联合超微血流技术(SMI)评估颈动脉斑块特征及稳定性的价值。方法回顾性分析2021年2月至2022年2月上饶市立医院收治的60例颈动脉粥样硬化患者的临床资料,患者均行CDFI和SMI检查,分析CDFI、SMI检查下颈动脉斑块的影像特征。以光学断层成像(OCT)为金标准,比较CDFI、SMI及CDFI联合SMI对颈动脉斑块稳定性的诊断效能。根据OCT检查结果将患者所测得的86个颈动脉斑块分为稳定组(稳定性斑块)55与易损组(易损性斑块)31个,比较两组SMI检查结果[达峰时间(TTP)、峰值强度(PI)],绘制ROC曲线评估SMI评估颈动脉斑块稳定性的价值。结果CDFI和SMI检查下,颈动脉斑块特征均以可见增强信号,提示伴有新生血管(CDFI:77.91%;SMI:82.56%),新生血管位置均以近心端底部为主(CDFI:85.07%;SMI:90.14%),两种检查信号类型均以单数或双数较短的线样增强信号为主(CDFI:38.37%;SMI:40.70%)。TTP、PI对颈动脉斑块稳定情况评估效果良好,Cut-off值分别为8.20 db、12.93 s。CDFI、SMI及CDFI联合SMI评估颈动脉斑块稳定性的特异度、灵敏度、准确度、阳性预测值、阴性预测值比较差异无统计学意义;CDFI联合SMI评估的灵敏度高于CDFI,差异有统计学意义(P<0.05)。结论CDFI和SMI检查下,多数颈动脉斑块均有位于近心端底部的新生血管生成,多表现单数或双数的较短的线样增强信号,上述两种检查方式对颈动脉血管稳定性均有良好的评估效能,其联合诊断评估效能更佳。

Objective To explore the value of color Doppler flow imaging(CDFI)combined with superb microvascular imaging(SMI)on evaluating the characteristics and stability of carotid plaque.Methods The clinical data of 60 patients with carotid atherosclerosis who were treated in Shangrao Municipal Hospital from February 2021 to February 2022 were retrospectively analyzed,all patients received CDFI and SMI,the imaging characteristics of carotid plaques detected by CDFI and SMI were analyzed.With optical tomography(OCT)as the gold standard,the diagnostic efficiency of CDFI,SMI and CDFI combined with SMI on carotid plaque stability was compared,86 carotid plaques measured by patients were divided into the stable group(stable plaques)and the vulnerable group(vulnerable plaques)according to the results of OCT examination,including 55 and 31 plaques,respectively,the results of SMI examination(time to peak[TTP],peak intensity[PI])were compared between groups,and ROC curve was drawn to evaluate the value of SMI on evaluating the stability of carotid plaque.Results Under CDFI or SMI detection,the characteristics of carotid plaque were all enhanced signals,suggesting that there were neovascularization(CDFI:77.91%;SMI:82.56%),and the location of neovascularization was mainly at the bottom of the proximal end(CDFI:85.07%;SMI:90.14%),both types of detection signals were dominated by single or double short line-like enhanced signals(CDFI:38.37%;SMI:40.70%).TTP and PI were effective in evaluating the stability of carotid plaque,and the Cutoff values were 12.93 s and 8.20 dB respectively.There were no statistical difference in the specificity,sensitivity,accuracy rate,positive predictive value and negative predictive value of CDFI,SMI and CDFI combined with SMI in evaluating the stability of carotid plaque;the sensitivity of CDFI combined with SMI was higher than that of CDFI,and the difference was statistically significant(P<0.05).Conclusion Under the detection of CDFI or SMI,most carotid plaques have neovascularization at the base of the proximal end,and most of them show single or double short linear enhancement signals,the above two detection methods have good evaluated efficiency on carotid artery stability,and their combined diagnostic evaluation efficiency is better.