环境压力对颈动脉斑块超声造影(CEUS)定量参数的影响

 目的  应用超声造影(contrast-enhanced ultrasound, CEUS)检测急性脑梗死患者颈动脉斑块内新生血管的定量指标,初步探讨斑块环境压力对CEUS定量参数的影响。方法  急性缺血性大动脉粥样硬化性脑梗(large artery atherosclerosis stroke, LAAS)患者62例入组脑梗组。选取同期住院且年龄、性别匹配,无心脑血管事件发生史的动脉硬化患者54例作为对照组。选取颈动脉优势斑块行CEUS,脱机定量分析获取斑块强度均值(the mean of time-intensity curve,TIC-M)、拟合曲线峰值(fitting curve-peak, FC-P)和拟合曲线下面积(fitting curver-area under the curve, FC-AUC)。采用超声射频技术动脉僵硬度分析软件(quality arterial stiffness, QAS)获取斑块局部收缩压(local pressure-systolic,Loc Psys)和局部舒张压(local pressure-diastolic, Loc Pdia)。参数与斑块局部压力的相关性采用Pearson相关分析。结果  脑梗组与对照组相比,Loc Psys和Loc Pdia差异均无统计学意义。在脑梗组,患者颈动脉斑块造影参数TIC-M、PC-P和FC-AUC均大于对照组(P＜0.05)。TIC-M与Loc Psys和Loc Pdia呈负相关(r=-0.470和-0.682,P均＜0.05)。FC-P与Loc Psys和Loc Pdia呈负相关(r=-0.480和-0.691, P均＜0.05)。FC-AUC与Loc Pdia呈负相关(r=0.493, P＜0.05)。结论  颈动脉斑块内新生血管的CEUS定量指标与斑块周围压力密切相关,CEUS评估易损斑块应考虑其周围压力的影响。

Effect of ambient pressure around carotid plaque on quantitative parameters of contrast-enhanced ultrasound (CEUS)

Objective  To detect the quantitative parameters of neovascularization in carotid plaques of patients with acute cerebral infarction using contrast-enhanced ultrasound (CEUS) and to evaluate the effect of ambient pressure around carotid plaques. Methods  Six-two patients with large artery atherosclerosis stroke (LAAS) were recruited as the infarction group, and 54 patients with atherosclerosis who were age-and gender-matched without cerebrovascular events were selected as the control subjects. The advantage plaques were imaged by CEUS. The mean of time-intensity curve (TIC-M), the peak (FC-TP) and area under the curve (FC-AUC) obtained from fitting curves were analyzed off-line. Local pressure-systolic (Loc Psys) and pressure-diastolic (Loc Pdia) were obtained by software (quality arterial stiffness, QAS) for analyzing arterial stiffness. The correlations between parameters of contrast-enhanced ultrasound and local pressure were analyzed by Pearson correlation analysis. Results  There was no significant difference in Loc Psys and Loc Pdia between the two groups. The TIC-M, PC-P and FC-AUC in the infarction group were significantly larger than those in the control group (all P<0.05). TIC-M was negatively correlated with Loc Psys and Loc Pdia, respectively (r=-0.470 and -0.682, all P<0.05). FC-P was negatively correlated with Loc Psys and Loc Pdia, respectively (r=-0.480 and -0.691, all P<0.05). There was a negative correlation between FC-AUC and Loc Pdia (r=0.493, P<0.05). Conclusions  The parameters of neovascularization of carotid plaques were closely related to the ambient pressure around the plaque. The ambient pressure around the plaque should be considered when vulnerable plaques were assessed by CEUS.