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目的应用多层螺旋CT血管成像(MDCTA)可显示颈动脉斑块对比度增强。本研究的目的是探讨颈动脉斑块强化(CPE)与微血管密度之间的相关性。材料与方法本研究经IRB批准。应用16层螺旋CT对29例(男20例,平均63岁)有症状病人进行前瞻性分析,对比剂注射前和注射后均行CT扫描并对斑块强化进行分析。病人行“整块”颈动脉内膜剥脱术,随后制备组织切片并对微血管进行量化。采用采用Logistic回归分析及ROC曲线分析,并计算曲线下面积。结果 CPE程度和微血管密度之间有显著相关性(P=0.009;ρ=0.553)。ROC曲线分析证实其相关性,10、15、20和25HU的CPE曲线下面积区域分别为0.906、0.735、0.644和0.546。CPE和新生血管形成程度之间差异具有统计学意义(P=0.0003)。结论初步研究结果表明,CPE可能与微血管密度之间存在相关性。组织学分析似乎能表明斑块内新血管形成的程度与CPE的相关性具有统计学意义。
Objective To evaluate the contrast enhancement of carotid artery plaque by multi-slice spiral CT angiography (MDCTA). The purpose of this study was to explore the correlation between carotid plaque enhancement (CPE) and microvessel density. Materials and Methods This study was approved by the IRB. Twenty-nine patients (20 male, average 63 years old) with symptomatic disease were prospectively analyzed by 16-slice spiral CT. CT scan before and after contrast injection was performed and plaque enhancement was analyzed. Patients underwent “carotid endarterectomy” followed by histological sectioning and microvessel quantification. Using Logistic regression analysis and ROC curve analysis, and calculate the area under the curve. Results There was a significant correlation between the degree of CPE and microvessel density (P = 0.009; ρ = 0.553). ROC curve analysis confirmed its correlation. The area under the CPE curves of 10, 15, 20 and 25HU were 0.906, 0.735, 0.644 and 0.546, respectively. The difference between CPE and neovascularization was statistically significant (P = 0.0003). Conclusions Preliminary findings suggest that there may be a correlation between CPE and microvessel density. Histological analysis seems to indicate that the degree of neovascularization within the plaque correlates with CPE statistically significant.