对颈动脉粥样硬化溃疡斑块内超声造影的定量研究

目的 了解颈动脉粥样硬化溃疡斑块内新生血管的血流动力学定量特点。方法 将颈动脉粥样硬化易损斑块患者按有无临床缺血症状分为症状组与非症状组，比较两组患者溃疡斑块发生率；对易损斑块进行超声造影检查，比较溃疡斑块和非溃疡斑块的造影剂到达时间、达峰时间、斑块内新生血管增强密度和斑块峰值强度/颈动脉管腔峰值强度比值差异。分析两组斑块血流动力学特点及斑块内新生血管的定量特征。结果 入组41例患者，共有48个易损斑块。症状组溃疡斑块发生率为68.2%，无症状组溃疡斑块发生率为38.5%，差异有统计学意义（P <0.05）。超声造影检查显示溃疡斑块组造影剂到达时间、斑块内新生血管增强密度和斑块峰值强度/颈动脉管腔峰值强度比值较非溃疡斑块组差异有统计学意义（7.21±2.17 s vs 10.32±3.17 s，P <0.05；15.1±6.4 dB vs 11.3±5.1 dB，P <0.05；0.64±0.17 vs 0.47±0.21，P <0.05)。结论 缺血症状组溃疡斑块的发生率较高；溃疡斑块组的新生血管密度高于非溃疡斑块组。

Contrast-Enhanced Ultrasonography for the Detection of Ulcerated Plaques with Neoangiogenesis in Carotid Artery

Objective To observe and quantitative analysis neoangiogenesis within ulcerated plaques and determine the correlation between the ulcerated plaques enhancement and clinical symptoms in patients with contrast-enhanced ultrasonography angiography in carotid atherosclerotic plaques. Methods Fourty-eight plaques of 41 patients with soft plaque and/or mixed plaque were studied with standard and contrast-enhanced ultrasonography. Contrast enhancement in the ulcerated plaque was evaluated with visual interpretation and quantitative analysis. Results Arrive time （7.21）, enhanced intensity in the plaque （15.1） and the ratio of enhanced intensity in the plaque to that in the lumen of the carotid artery （0. 64） in symptomatic patients were significantly greater than those in asymptomatic patients （P〈0.05, respectively）. Conclusion The incidence of ulcerated plaques in symptomatic patients is higher than that of asymptomatic patients; The density of angiogenesis in ulcerated plaques is higher than that of non-ulcerated plaques.