微血流模式背景下超声造影评估颈动脉斑块稳定性的价值

目的 评估微血流模式造影在计量位于颈动脉之间斑块内新长出的血管密度与数量的临床价值.方法 选取郑州大学第一附属医院148例颈动脉粥样硬化患者,共255枚颈动脉斑块,主要包括低回声和混合回声的斑块.常规超声扫查患者双侧颈动脉,同时记录斑块的相关信息,然后对颈动脉斑块进行超声造影(CEUS)检查及微血流模式(SMI)环境下...

Value of contrast enhanced ultrasound in the stability of carotid plaque under the background of superb microflow imaging

Objective To evaluate the clinical value of ultrasound contrast under microflow pattern in measuring the density and number of newly grown blood vessels in plaques between carotid arteries.Methods Totally 148 patients with carotid atherosclerosis treated in the First Affiliated Hospital of Zhengzhou University were sampled,including 255 carotid plaques,including hypoechoic and mixed echo plaques.The bilateral carotid arteries of the patients were scanned by conventional ultrasound,and the related information of plaques was recorded at the same time,and then the carotid plaques were examined by contrast-enhanced ultrasound(CEUS)and evaluated by contrast-enhanced ultrasound(CEUS)under the background of microflow mode(SMI).The location and number of new blood vessels in the plaque in the cervical artery during CEUS and CEUS with SMI were observed and recorded,and the images were stored.After the completion of the examination operation,according to the blood flow classification criteria,to explore the consistency of CEUS evaluation of the number of new blood vessels in the plaque in the cervical artery and CEUS with SMI.Results Among the 255 plaques,there were 76 plaques with thickness<2.0mm,66 plaques with 2.0-2.9mm,59 plaques with 3.0-3.9mm,and 54 plaques with≥4.0mm.The consistency of neovascularization grading in plaques detected by CEUS and CEUS combined SMI mode was Kappa=0.710 and P<0.05.Four groups of plaques with thickness<2.0mm,thickness 2.0-2.9mm,thickness 3.0-3.9mm and thickness≥4.0mm were tested by Kappa,the Kappa values of the four groups were 0.617,0.667,0.679 and 0.640,respectively,P<0.05,indicating that the consistency of the two methods in detecting the number of neovascularization in plaques with different thickness was high.Compared with CEUS alone,CEUS combined with SMI mode could find more neovascularization in the plaque(χ2=5.381,P<0.05).Conclusion CEUS and CEUS combined with SMI mode are consistent in detecting new blood vessels in carotid plaque,and CEUS combined with SMI mode can improve the detection rate of new blood vessels in carotid plaque compared with CEUS mode alone.