64层螺旋CT血管造影及超声造影评价颈动脉斑块

目的 探讨64层螺旋CT血管造影(MSCTA)及超声造影(CEUS)在评价颈动脉斑块中的价值.资料与方法 37例颈动脉斑块狭窄患者于1周内分别行MSCTA及CEUS检查,分析颈动脉内中膜厚度/颈动脉管壁厚度、狭窄比率、斑块表面形态,采用CEUS观察斑块内新生血管情况,将斑块分为内中膜增厚型、稳定型及易损斑块.结果 37例共51处病变血管,MSCTA:颈动脉管壁增厚9处；斑块42处,其中稳定斑块27处,易损斑块15处.CEUS:颈动脉内中膜增厚11处；斑块40处,其中稳定斑块23处,易损斑块17处.MSCTA:轻度狭窄21处,中度狭窄15处,重度狭窄12处,闭塞3处；CEUS:轻度狭窄20处,中度狭窄16处,重度狭窄13处,闭塞2处.MSCTA与CEUS对颈动脉斑块狭窄(Kappa=0.71,P＜ 0.05)及斑块稳定性(Kappa=0.69,P＜0.05)评价一致性较好.结论 MSCTA与CEUS对评价颈动脉斑块狭窄及斑块稳定性具有较好的一致性.

Evaluation of Carotid Atherosclerosis Using 64-slice CT Angiography and Contrast-enhanced Ultrasound

Purpose To explore the value of 64-slice CT angiography (MSCTA) and contrast-enhanced ultrasound (CEUS) in the diagnosis of carotid atherosclerosis.Materials and Methods 37 patients with carotid atherosclerosis underwent MSCTA and CEUS within one week.Intima-media thickness (IMT),carotid artery wall thickness (CAWT),carotid artery percent stenosis and surface morphology of the atherosclerotic plaques were analyzed.The neo-vasculization in the plaques after CEUS were observed,and plaques were further divided into IMT thickening,stable plaque and vulnerable plaque.Results 51 pathological changes of 37 patients were observed.MSCTA showed 9 carotic artery wall thickening and 42 plaques including 27 stable plaques and 15 vulnerable plaques.CEUS showed 11 intima-media thickening and 40 plaques,23 stable and 16 vulnerable.MSCTA showed 21 mild stenoses,15 moderate stenoses,12 severe stenoses,and 3 occlusions;CEUS showed 20 mild stenoses,16 moderate stenoses,13 severe stenoses,and 2 occlusions.MSCT and CEUS had good consistency in diagnosing carotid artery stenosis (Kappa=0.71,P < 0.05) and plaque stability (Kappa=0.69,P < 0.05).Conclusion MSCTA has good agreement with CEUS in assessing carotid atherosclerosis.