中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
12期
5244-5247
,共4页
刘焱%郭君%郭德颖%王新楠
劉焱%郭君%郭德穎%王新楠
류염%곽군%곽덕영%왕신남
颈动脉%椎动脉%超声造影%新生血管
頸動脈%椎動脈%超聲造影%新生血管
경동맥%추동맥%초성조영%신생혈관
Carotid arteries%Vertebral artery%Contrast-enhanced ultrasound%Neovascularization
目的探讨实时超声造影技术检测颈动脉硬化斑块及其内部新生血管的超声造影特征。方法53例颈动脉粥样硬化患者行颈动脉、椎动脉常规检查及超声造影检查，其中对49个粥样硬化斑块行超声造影，观察超声造影时管腔狭窄程度及斑块造影增强模式，分析斑块内新生血管的超声造影表现与斑块回声之间的关系。结果在超声造影过程中清晰显示中内膜厚度并显示出常规超声未发现的9个斑块；对于诊断颈动脉、椎动脉重度狭窄和闭塞，常规超声与超声造影间、常规超声与DSA间均有统计学差异（ P＜0.05）。49个斑块中有35个超声造影表现为弱增强，增强模式以自外膜向中心增强为主，占54％（19/35），其中低回声斑块占53％（10/19）；其次是自内膜及外膜向中心增强，占31％（11/35）；自内膜向中心增强最少，占14％（5/35）。低回声斑块、等回声斑块、混合回声斑块组增强率分别为93％、71％、81％，明显高于高回声斑块组27％（ P＜0.05）。结论超声造影提高了颈动脉斑块显示率，有助于判断颈动脉狭窄程度，可敏感地显示斑块动态增强形式，并能够显示斑块内新生血管特征，评估斑块的稳定性，为临床治疗及评价预后提供了有效方法。
目的探討實時超聲造影技術檢測頸動脈硬化斑塊及其內部新生血管的超聲造影特徵。方法53例頸動脈粥樣硬化患者行頸動脈、椎動脈常規檢查及超聲造影檢查，其中對49箇粥樣硬化斑塊行超聲造影，觀察超聲造影時管腔狹窄程度及斑塊造影增彊模式，分析斑塊內新生血管的超聲造影錶現與斑塊迴聲之間的關繫。結果在超聲造影過程中清晰顯示中內膜厚度併顯示齣常規超聲未髮現的9箇斑塊；對于診斷頸動脈、椎動脈重度狹窄和閉塞，常規超聲與超聲造影間、常規超聲與DSA間均有統計學差異（ P＜0.05）。49箇斑塊中有35箇超聲造影錶現為弱增彊，增彊模式以自外膜嚮中心增彊為主，佔54％（19/35），其中低迴聲斑塊佔53％（10/19）；其次是自內膜及外膜嚮中心增彊，佔31％（11/35）；自內膜嚮中心增彊最少，佔14％（5/35）。低迴聲斑塊、等迴聲斑塊、混閤迴聲斑塊組增彊率分彆為93％、71％、81％，明顯高于高迴聲斑塊組27％（ P＜0.05）。結論超聲造影提高瞭頸動脈斑塊顯示率，有助于判斷頸動脈狹窄程度，可敏感地顯示斑塊動態增彊形式，併能夠顯示斑塊內新生血管特徵，評估斑塊的穩定性，為臨床治療及評價預後提供瞭有效方法。
목적탐토실시초성조영기술검측경동맥경화반괴급기내부신생혈관적초성조영특정。방법53례경동맥죽양경화환자행경동맥、추동맥상규검사급초성조영검사，기중대49개죽양경화반괴행초성조영，관찰초성조영시관강협착정도급반괴조영증강모식，분석반괴내신생혈관적초성조영표현여반괴회성지간적관계。결과재초성조영과정중청석현시중내막후도병현시출상규초성미발현적9개반괴；대우진단경동맥、추동맥중도협착화폐새，상규초성여초성조영간、상규초성여DSA간균유통계학차이（ P＜0.05）。49개반괴중유35개초성조영표현위약증강，증강모식이자외막향중심증강위주，점54％（19/35），기중저회성반괴점53％（10/19）；기차시자내막급외막향중심증강，점31％（11/35）；자내막향중심증강최소，점14％（5/35）。저회성반괴、등회성반괴、혼합회성반괴조증강솔분별위93％、71％、81％，명현고우고회성반괴조27％（ P＜0.05）。결론초성조영제고료경동맥반괴현시솔，유조우판단경동맥협착정도，가민감지현시반괴동태증강형식，병능구현시반괴내신생혈관특정，평고반괴적은정성，위림상치료급평개예후제공료유효방법。
Objective To explore the feature of neovascularization within carotid atherosclerotic plaques by real-time contrast-enhanced ultrasonography .Methods 53 patients with carotid arterial angiosclerosis were examined by routine ultrasonography.Then 49 carotid atherosclerotic plaques with contrast-enhanced ultrasonography(CEUS). Imaging performance of the degree of carotid arterial stenosis and contrast enhancement mode were observed and evaluated.To analyze the relationships of the neovascularization enhancement feature with plaque echogenicity . Results 9 plaques were found and the intima-media thickness was displayed more clearly after injection contrast agent.There were significantly different between routine ultrasonography with CEUS and DSA to diagnose severe stenosis and obliteration ( P <0.05 ) .35 of 49 carotid atherosclerotic plaques were enhanced poorly in contrast-enhanced ultrasonography ,19 plaques of them enhanced from periphery to the center of plaques about 54%.Low level echo plaques to occupy 53% in them.31% were enhanced from intima and extima to the center of plaques .Only 14%plaques enhanced from intima to the center .The enhancement rate of low ,equal ,mixed echo group were 93%, 71%,81%, which enhanced intensity more than high echo group ( P <0.05 ) .Conclusion Contrast-enhanced ultrasound imaging can increase the presentation rate of carotid plaques and revealed the feature of neovascularization ,which is help for appraising the carotid artery stenosis .To provide valuable informations of plaque risk stratification and modus operandi to clinical .
