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颈动脉粥样硬化的易损性斑块是诱发缺血性脑卒中的重要危险因素,易损斑块不仅可导致颈动脉管腔狭窄引起脑血管缺血性症状,更重要的是继发血栓形成导致脑梗死等疾病的发生。动脉粥样硬化斑块的产生和发展与斑块内新生血管形成密切相关,研究发现新生血管可促进粥样硬化病变发展,甚至诱发斑块内出血和斑块破裂及其并发症发生,是造成斑块易损性的重要因素之一。目前针对颈动脉斑块的影像学检查方法很多,如常规超声、计算机断层摄影术血管造影(CTA)、磁共振成像(MR)技术、动脉造影、血管内超声(IVUS)、光学相干断层扫描(OCT)等,近年来超声造影(CEUS)技术发展突飞猛进,在检测动脉粥样硬化斑块新生血管方面发挥着越来越大的作用,CEUS对活体颈动脉斑块内新生血管的检测具有很高的敏感性,而且具有定量评价的功能,但由于其费用高、有创性、需用造影剂、操作相对费时等缺陷,应用有一定的局限性。由日本东芝公司研发的超微血管成像技术(SMI),作为一种新型血管成像技术,可以探测到更加微小的血管以及流速更低的血流,而且该技术不使用造影技术的辅助。SMI技术有望成为一种新的颈动脉粥样硬化斑块内新生血管的无创性检测方法,通过评价斑块内新生血管的情况,进一步评估斑块的稳定性。
Vulnerable carotid atherosclerosis plaque is an important risk factor for inducing ischemic stroke. Vulnerable plaque can not only lead to cerebral ischemic symptoms caused by stenosis of carotid artery, more importantly, secondary thrombosis Formation led to the occurrence of cerebral infarction and other diseases. The production and development of atherosclerotic plaque is closely related to the formation of plaque neovascularization. It is found that angiogenesis can promote the development of atherosclerotic lesions, and even cause plaque hemorrhage and plaque rupture and its complications, Block vulnerability is one of the important factors. Currently there are many imaging methods for carotid plaque, such as routine ultrasound, computed tomography angiography (CTA), magnetic resonance imaging (MR), arteriography, intravascular ultrasound (IVUS), optical coherence tomography OCT), etc. In recent years, the development of CEUS has progressed by leaps and bounds and plays an increasingly important role in the detection of atherosclerotic plaque neovascularization. CEUS has a high detection rate of neovascularization in living carotid plaques Sensitivity, but also has the function of quantitative evaluation. However, due to its high cost, invasiveness, the need for contrast media, the relatively time-consuming operation and other defects, the application has its own limitations. Micro-vascular imaging (SMI), developed by Toshiba, Japan, is a new angiography technique that detects smaller blood vessels and blood flow at lower velocities without the aid of contrast technology. SMI technology is expected to become a new noninvasive detection method of neovascularization in carotid atherosclerotic plaque. The evaluation of plaque neovascularization will further assess the stability of plaque.