超微血管成像与超声造影评估颈动脉斑块新生血管的对比研究

目的对比分析超微血管成像(SMI)和超声造影诊断颈动脉粥样硬化斑块内新生血管的临床应用价值。方法对64例患者(99枚颈动脉粥样硬化斑块)分别行SMI和超声造影检查,比较SMI和超声造影显示颈动脉斑块内新生血管的阳性率和位置差异,以及两种方法诊断斑块内新生血管的一致性。结果超声造影对斑块内新生血管的检出率明显高于SMI(79.80%vs.53.54%),差异有统计学意义(χ~2=15.364,P=0.000)。两种方法检测斑块内新生血管分布的区域差异有统计学意义(χ~2=8.257,P<0.05)。Kappa检验显示SMI与超声造影检测斑块内新生血管具有一致性(Kappa=0.464,P=0.000)。结论 SMI与超声造影诊断斑块内新生血管各有优势,超声造影敏感性高,更易显示斑块基底部新生血管;SMI具有简便、无创、价格低廉的优点,可作为粥样硬化斑块的长期随访手段,两者联合应用可为临床提供更为准确的斑块易损信息。

Comparative study of superb microvascular imaging and contrast-enhanced ultrasound in diagnosing neovascularization in carotid atherosclerotic plaque

ObjectiveTo compare and analyze the clinical application value of superb microvascular imaging(SMI)and contrast-enhanced ultrasound(CEUS)in the diagnosis of neovascularization in carotid atherosclerotic plaques.MethodsSixty-four patients(99 carotid atherosclerotic plaques)were examined by SMI and CEUS,respectively,and the differences in the positive rate and location of neovascularization in carotid plaque were compared between SMI and CEUS.The consistency of the two methods in the diagnosis of neovascularization in plaque was compared.ResultsIn 99 carotid plaques,the detection rate of neovascularization in plaques by CEUS was significantly higher than that of SMI(79.80% vs.53.54%),and the difference was statistically significant(χ~2=15.364,P=0.000).The regional differences in the distribution of neovascularization in the plaque were statistically significant(χ~2=8.257,P<0.05).Kappa test showed there was a certain consistency between SMI and CEUS in detecting neovascularization in plaques(Kappa=0.464,P=0.000).ConclusionSMI and CEUS have their own advantages in diagnosing neovascularization in plaques. The sensitivity of CEUS is high,and it is easy to display neovascularization at the base of the plaque.SMI has the advantages of simplicity,non-invasiveness and low price,and can be used as a long-term follow-up method for atherosclerotic plaques.The combination of the two methods can provide more accurate plaque vulnerability information.