超声造影评价颈动脉斑块内新生血管形成与临床症状的关系

目的 分析超声造影显示颈动脉粥样硬化斑块增强强度与患者临床症状之间的关系.方法 颈动脉粥样硬化患者58例,分为有临床症状及无症状2组.常规超声评价颈动脉斑块回声类型,超声造影观察斑块内增强强度并进行分级.分析斑块回声、斑块内增强情况与患者临床症状的关系.结果 有症状组69.4％的斑块超声造影出现增强且2级以上增强者达63.3％,而在无症状组58.3％的斑块超声造影表现为不增强,2级以上增强者仅为29.2％,2组间有显著性差异.结论 实时超声造影可敏感显示斑块内的动态增强过程,反应斑块内的新生血管形成,与患者的临床症状具有相关性.     

超声造影评价不同狭窄程度颈动脉粥样斑块内的新生血管形成

目的 评价灰阶谐波超声造影技术显示不同程度颈动脉狭窄患者动脉粥样硬化斑块内新生血管形成的价值.方法 疑诊颈动脉狭窄患者58例,共73个斑块.常规超声评价颈动脉斑块回声类型,超声造影实时观察斑块内增强强度并进行分级.动脉狭窄程度以X线动脉造影检查结果为准.比较不同狭窄程度及不同回声类型颈动脉斑块的增强强度.结果 颈动脉90%以下狭窄各组间斑块增强强度与动脉狭窄程度之间无相关性(P=0.358),但90%以上狭窄(包括闭塞)组斑块增强强度明显增加,两者之间差异有统计学意义(P=0.008).不同斑块回声类型的斑块增强强度差异有统计学意义(P=0.000).结论 超声造影能够实时观察颈动脉粥样硬化斑块的增强过程,反映斑块内新生血管的形成,从而为评价斑块的稳定性提供重要信息.

Abstract：

Objective To evaluate contrast-enhanced ultrasound imaging of carotid atherosclerosis with different stenostic degree as a clinical tool to study intraplaque neovascularization.Methods Fifty-eight patients suspected of carotid stenosis with 73 plaques were studied by standard and contrast-enhanced ultrasound.Plaque echogenicity at standard ultrasound were evaluated.Contrast enhancement within the plaques was categorized as 0 - 4 degree and compared to the stenosis degree and the plaque echogenicity.The degree of stenosis was determined by intravenous digital subtraction angiography.Results In the group with stenosis less than 90% ,stenosis degree was not associated with the grade of contrast enhancement (P =0.358),while the grade of enhancement was significantly higher in the group with sever stenosis(＞90%).The grades of enhancement were significantly different between plaques with different echogenicity (P =0.000).Conclusions Contrast-enhanced real-time ultrasound imaging can demonstrate the enhancement of carotid plaques non-invasively,which is helpful for assessing intraplaque neovascularization and provide valuable information for plaque risk stratification     

超声造影评价不同狭窄程度颈动脉粥样斑块内的新生血管形成

Objective To evaluate contrast-enhanced ultrasound imaging of carotid atherosclerosis with different stenostic degree as a clinical tool to study intraplaque neovascularization.Methods Fifty-eight patients suspected of carotid stenosis with 73 plaques were studied by standard and contrast-enhanced ultrasound.Plaque echogenicity at standard ultrasound were evaluated.Contrast enhancement within the plaques was categorized as 0 - 4 degree and compared to the stenosis degree and the plaque echogenicity.The degree of stenosis was determined by intravenous digital subtraction angiography.Results In the group with stenosis less than 90% ,stenosis degree was not associated with the grade of contrast enhancement (P =0.358),while the grade of enhancement was significantly higher in the group with sever stenosis(＞90%).The grades of enhancement were significantly different between plaques with different echogenicity (P =0.000).Conclusions Contrast-enhanced real-time ultrasound imaging can demonstrate the enhancement of carotid plaques non-invasively,which is helpful for assessing intraplaque neovascularization and provide valuable information for plaque risk stratification     

超声造影评价颈动脉斑块增强强度与颈总动脉内-中膜厚度的相关性

目的：探讨颈动脉粥样硬化患者的颈总动脉内-中膜厚度（intima-media thickness,IMT）与颈动脉斑块增强强度（enhanced intensity,EI）的相关性.方法：2009年2011年在复旦大学附属中山医院行颈动脉超声造影（contrast-enhanced ultrasound,CEUS）检查的颈动脉粥样硬化患者135例,共167个颈动脉斑块.采用荷兰Philips iU22超声诊断仪,L9-3线阵探头.所有患者行CEUS检查时,仪器参数设置保持一致.超声造影剂采用Sono Vue,剂量2.0 mL.根据斑块有无增强及增强强度,将斑块EI分为0～4级,采用QLAB定量分析软件分别测量颈总动脉IMT,计算颈动脉斑块EI、斑块EI与颈动脉管腔EI的比值,并分析其与相应颈总动脉IMT的相关性.结果：167条颈动脉中有6条未测及IMT,不同CEUS斑块增强分级组的IMT测值之间差异无统计学意义（P=0.994）.颈总动脉IMT与斑块EI（P=0.687）及比值（P=0.852）无相关性.结论：颈动脉斑块EI与颈总动脉IMT无相关性,临床上可根据具体情况选择合适的筛选和随访手段.     

血管内皮生长因子在早产儿视网膜病变中的作用研究进展

视网膜新生血管形成是眼部多种疾病共有的病理特点,其引发的疾病已成为目前致盲的重要原因.VEGF家族在新生血管形成中扮演着重要的角色,其通过影响细胞增生、细胞迁移、诱导毛细血管腔形成,从而促进新生血管的生成和生长.本文以早产儿视网膜病变为例,介绍VEGF家族及其受体,在早产儿视网膜病变的病理过程中的作用和针对其作用机制可采取的相应防治方法.     

超声剪切波弹性及频散成像技术检测健康成人肝脏黏弹性的参考值范围

目的： 探讨基于超声剪切波弹性成像（shear wave elastography，SWE）及剪切波频散成像（shear wave dispersion，SWD）技术检测健康成人肝脏黏弹性的最优测量方法及医学参考值范围。方法： 选择2020年5月至10月复旦大学附属中山医院的健康体检者50例，行肝脏SWE及SWD检测，分析不同肝脏检测部位、不同取样面积及年龄、性别对测值的影响，进一步确定健康人群的肝脏黏弹性的参考值范围。结果： 肝右叶S5/S6段切面检测的成功率高于肝左叶最大切面（100%vs 76%），结合肝右叶测值内部一致性和离散程度均优于肝左叶测值，肝右前叶为测量的最佳位置；不同取样面积（直径10 mm及20 mm）的肝脏SWE及SWD测值差异无统计学意义；不同年龄组及不同性别组间肝脏SWE及SWD测值差异无统计学意义。结论： 应用剪切波黏弹性技术检测肝脏黏弹性成功率高，稳定性好，肝右前叶为最佳测量部位，不同取样面积、性别及年龄对测值无明显影响。推算肝脏SWE参考值范围为3.93~8.75 kPa；肝脏SWD参考值范围为8.80~14.99 m/（s·MHz）。