颈动脉粥样硬化斑块超声影像特征

目的 :探讨颈动脉重度狭窄时斑块及其继发改变的声像图特点。材料和方法 :2 0例 2 2条颈动脉内膜切除术患者 ,术前、术后离体标本行超声检测 ,并与相应层面的病理切片相对照。结果 :2 2条所研究的斑块中硬斑 3条 ( 13 .6% ) ,软斑 8条 ( 3 6.4% ) ,混合斑 11条 ( 5 0 .0 % ) ;其中含有无回声的斑块 4条 ( 18.2 % ) ;回声分布均匀的斑块 2条 ( 9.1% )。显示斑块合并溃疡的敏感性、特异性和准确性分别为 72 .7%、3 6.4%和 5 4.5 % ,显示斑块合并血栓形成的敏感性、特异性和准确性分别为 3 5 .7%、10 0 %和 5 9.1%。结论 :颈动脉重度狭窄时容易形成软斑和混合斑 ,超声可明确提示。对伴有溃疡、含有无回声或不均匀低回声和超声显示有血栓的斑块 ,应引起高度重视 ,并作为临床选择治疗方法的根据。

Echographic Features of Atherosclerostic Plaque in Carotid Arteries

Purpose: To evaluate the ultrasonic characterization of atheromatous plaques and their complicated alterations. Materials and Methods: 20 patients (22 lesions) under going carotid endarterectomy were examed by high resolution B mode ultrasound. The postoperative specimens of carotid plaque were also examed by ultrasound and the images were compared with its transverse pathological sections. Results: There were 3 hardplaques (13.6%), 8 softplaques (36.4%) and 11 mixedplaques (50.0%) in those patients. Among the 22 lesions, 2 (9.1%) showed homogeneous echogenicity and 4 (18.2%) echofree. The sensitivity, specifity, and accuracy of ultrasonography was 72.7%, 36.4% and 54.5% respectively for ulceratire plaque ,and 35.7%, 100% and 59.1% respectively for thrombosis. Conclusion: Softplaques and mixedplaques could be more frequently encountered in carotid antery of higher grade stenosis. The ulceratire plague, anecho or inhomogeneous hypoecho plaque and thrombosis through ultrasonic characterization should be of important clinical value in for choosing the treatment methods.