超声造影评价颈动脉斑块增强强度与颈总动脉内-中膜厚度的相关性

目的：探讨颈动脉粥样硬化患者的颈总动脉内-中膜厚度（intima-media thickness,IMT）与颈动脉斑块增强强度（enhanced intensity,EI）的相关性.方法：2009年2011年在复旦大学附属中山医院行颈动脉超声造影（contrast-enhanced ultrasound,CEUS）检查的颈动脉粥样硬化患者135例,共167个颈动脉斑块.采用荷兰Philips iU22超声诊断仪,L9-3线阵探头.所有患者行CEUS检查时,仪器参数设置保持一致.超声造影剂采用Sono Vue,剂量2.0 mL.根据斑块有无增强及增强强度,将斑块EI分为0～4级,采用QLAB定量分析软件分别测量颈总动脉IMT,计算颈动脉斑块EI、斑块EI与颈动脉管腔EI的比值,并分析其与相应颈总动脉IMT的相关性.结果：167条颈动脉中有6条未测及IMT,不同CEUS斑块增强分级组的IMT测值之间差异无统计学意义（P=0.994）.颈总动脉IMT与斑块EI（P=0.687）及比值（P=0.852）无相关性.结论：颈动脉斑块EI与颈总动脉IMT无相关性,临床上可根据具体情况选择合适的筛选和随访手段.

Correlation of Intima-Media Thickness of Carotid Artery and Intraplaque Enhanced -Intensity under Contrast-Enhanced Ultrasound

Objective：To explore the correlation of intima-media thickness（IMT） of carotid artery（CCA） and the enhanced intensity（EI） of carotid plaque contrast-enhanced ultrasound（CEUS） in patient with carotid atherosclerosis.Methods：CEUS were performed on 135 patients from 2009 to 2011.Bilateral atherosclerotic lesions were detected in 32 patients.Therefore,a total of 167 carotid arteries with plaques were documented and analyzed.Sonographic examinations were performed with ultrasound instruments equipped with low mechanical index contrast imaging software.IMT of CCA was measured with QLAB software.Contrast-enhancement within the plaque was categorized as grade 0 to grade 4 by visual interpretation and evaluated by quantitative analysis.EI of carotid plaque and the ratio of EI within the plaque to that in the lumen of the carotid artery were calculated.The correlation of EI and ratio with IMT of CCA was analyzed.Results：IMT was not measured on 6 carotid arteries.In 161 carotid arteries,there was no significant difference in IMT among patients with different grades of intraplaque enhancement on CEUS （P =0.994）.IMT was not associated with EI （P =0.687） and ratio （P =0.852）.Conclusions：EI of carotid plaque is not associated with the IMT of CCA.Appropriate screening and follow-up means should be selected according to the specific circumstances in clinic.