超声造影技术评价颈动脉粥样硬化斑块稳定性的临床研究

目的:探讨超声造影技术评价颈动脉粥样硬化斑块稳定性的临床价值,为动脉粥样硬化诊断准确性提供参考。方法:根据实时超声造影检查的回声图像特点将该院53例(59个斑块)颈动脉粥样硬化斑块患者分为软斑组(24个)、混合斑组(18个)、硬斑组(17个),比较3组的造影增强率、造影增强程度分级,并对各类型斑块的时间-强度进行定量分析。结果:59个斑块中有40个呈现不同程度的增强,增强率为67.80%,其中软斑组、混合斑组、硬斑组超声增强率分别为87.50%、72.22%、35.29%,差异具有统计学意义(P0.05);造影增强程度Ⅰ级和Ⅲ级在三组间差异具有统计学意义(P0.05),其中硬斑组造影增强程度Ⅰ级个数较软斑组和混合斑组多,软斑组造影增强程度Ⅲ级个数较混合斑组和硬斑组多,差异均有统计学意义(P0.05);软斑组达峰时间、平均渡越时间均低于混合斑组和硬斑组,斑块峰值强度高于混合斑组和硬斑组,混合斑组达峰时间、平均渡越时间均低于硬斑组,斑块峰值强度高于硬斑组,差异均具有统计学意义(P0.05)。结论:超声造影技术可无创性地通过造影增强实时反映出颈动脉粥样硬化斑块内的新生血管情况,提供参数成像与定量分析,正确评价斑块的稳定性。

Clinical Study on Evaluation of Carotid Atherosclerotic Plaque Stability byContrast-enhanced Ultrasound

Objective:To investigate the clinical value of evaluation of carotid atherosclerotic plaque stability bycontrast-enhanced ultrasound, and to provide a reference for atherosclerosis diagnostic accuracy.Methods:53 cases (59 patches)ofpatients with carotid artery atherosclerotic plaque were divided into soft plaque group (24 patches), mixed plaque group (18 patches)andhard plaque group(17 patches) according to the characteristics of real-time ultrasound echo image angiography, compared the the contrastenhancement rate and enhancement degree between the 3 groups,and quantitative analysis of time-intensity for each type of patch.Results:40 of the 59 patches showed different degrees of enhancement and the enhancement rate was 67.80%. The ultrasoundenhancement rates of soft plaque group, mixed plaque group and hard plaque group were 87.50%,72.22% and 35.29% respectively,andthe difference was statistically significant (P<0.05); The I and III grade of contrast enhancement degree between the three groups wasstatistically significant (P<0.05), the number of I grade of contrast enhancement degree in hard plaque group was more than the soft andmixed plaque groups,the number of III grade of contrast enhancement degree in soft plaque group was more than the hard and mixedplaque groups, the difference was statistically significant (P<0.05); The peak time, average transit time of soft plaque group were lowerthan the mixed plaque group and hard plaque group, the plaque peak intensity is higher than the mixed plaque group and hard plaquegroup, the peak time and average transit time of the mixed plaque group was lower than the hard plaque group, the plaque peak intensitywas higher than the hard plaque group, and the differences were statistically significant (P<0.05).Conclusion:The ultrasound contrasttechnique can be used to reflect the new blood vessel of carotid atherosclerotic plaque in real time, and provide the parameter imagingand quantitative analysis to evaluate the stability of plaque.