超声造影在颈动脉疾病诊断中的应用

目的探讨超声造影在颈动脉疾病诊断中的应用价值。方法超声造影检查72例（92个斑块）颈动脉粥样硬化伴斑块形成患者，了解超声造影时斑块回声有无增强及血管充盈情况，并与数字减影血管造影（DSA）结果对照。结果颈动脉超声造影可清晰显示动脉内-中膜厚度，发现造影前未发现的斑块24个，并能勾勒出动脉斑块大小及形态。与DSA对照，应用超声造影诊断动脉粥样硬化所致颈部动脉闭塞的敏感性为55．6％、特异性为94．7％、准确性为82．0％。92个颈动脉斑块超声造影后69个增强，低回声、等回声、混合回声、强回声斑块新生血管检出率分别为89％、75％、70％和25％；斑块内造影剂到达时间迟于颈动脉（P〈0．05），达峰值时间较颈动脉延长（P〈0．05）。结论超声造影提高了颈动脉斑块的显示率，有助于判断动脉狭窄程度，并可显示斑块内新生血管，弥补了彩色多普勒超声的不足，为颈动脉疾病的诊断提供了一种安全、有效、无创的检查方法。

Application of constrast-enhanced ultrasound in carotid artery disease

Objective To investigate the value of contrast - enhanced ultrasonography in carotid artery disease. Methods Ninety - two carotid arterial plaques in Seventy - two patients with carotid arterial angiosclerosis were examined by contrast - enhanced uhrasonography. The enhancement and vascular filling were observed after injection of the agent, and the results were compared with DSA diagnosis. Results More plaques were found and the intima - media thickness was displayed more clearly after injection contrast agent. The morphology and structure of plaques could be observed at the same time. Compared with DSA, the sensitivity of occlusion detection by ceus was 55.6%, the specificity was 94.7%, and the accuracy was 82.0% respectively. Sixty - nine atherosclerotic plaques were enhanced by contrast - enhanced nhrasonography. The arrival time of plaques was significantly later than that of carotid （ P 〈 0.05 ） . Time to peak was prolonged compared to that of carotid （P 〈 0.05）. The detection rate of neovascularization in plaques of low level echo, equal echo, mixed echo and high echo by contrast - enchanced ultrasonography was 89%, 75%, 70% and 25%. Conclusion Contrast - enhanced ultrasound can improve the detection rate of carotid arterial plaque, determine the extent of artery stenosis, and observe the presence and degree of intraplaque neovascularization, it provide a safe, efficient and non - invasive technique in the diagnosis of carotid artery disease.