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目的:研究分析灰阶谐波超声造影(CEUS)评价斑块内新生血管与常规超声显示斑块类型的应用价值。方法:选取本院2013年8月-2015年10月收治颈动脉粥样硬化患者137例,共计158个斑块,采用灰阶谐波CEUS模式对斑块回声特征进行分析,观察造影增强模式特点。结果:通过检测发现均质斑块95个,非均质斑块53个,溃疡型斑10个;其中均质斑块中35个低回声,43个等回声,17个强回声;而采用灰阶谐波CEUS对新生血管内斑块进行检查,其均质斑块检出率为52.6%(50个),非均质斑块检出率为67.9%(36个),溃疡型斑块检出率为30%(3个)。通过对斑块回声检测率进行对比发现,灰阶谐波CEUS表现为低回声检出率明显高于等回声、强回声及溃疡型斑块;而低回声与非均质斑块新生血管检出率对比,差异无统计学意义(P>0.05)。其中90个CEUS增强中64个斑块表现为由管壁外膜向斑块内增强形式,余下26个斑块CEUS增强表现为由动脉管腔向斑块内蔓延的稀疏增强。结论:采用灰阶谐波CEUS可有效全面观察和评价颈动脉粥样硬化斑块内的新生血管的灌注特征,准确评价斑块内新生血管信息,对今后临床防治不稳定粥样斑块提供重要数据参考,增加了治疗方案制定的全面性与准确性。
Objective: To study the value of gray scale harmonic contrast echocardiography (CEUS) in evaluating plaque neovascularization and conventional ultrasound to display plaque type. Methods: A total of 158 plaques were selected from 137 patients with carotid atherosclerosis from August 2013 to October 2015 in our hospital. The characteristics of plaque echo were analyzed by gray-scale harmonic CEUS mode. . Results: There were 95 homogeneous plaques, 53 heterogeneous plaques and 10 ulcerated plaques. Among them, 35 were hypoechoic, 43 were echogenic and 17 were echogenic. The order harmonic CEUS was used to detect neovascular plaque. The detection rate of homogeneous plaque was 52.6% (50 cases), heterogeneous plaque was 67.9% (36 cases), ulcerative plaque Rate of 30% (3). By comparing the detection rate of plaque echo, it was found that the gray-scale harmonic CEUS showed that the detection rate of low echo was significantly higher than that of the equivalent echogenic, hyperechoic and ulcerative plaques; while the detection of low echo and heterogeneous plaque neovascularization Rate of comparison, the difference was not statistically significant (P> 0.05). Of the 90 CEUS enhancements, 64 plaques appeared to be enhanced from the adventitia to the plaque, and the remaining 26 plaques showed CEUS enhancement as a sparse enhancement from the arterial lumen into the plaque. Conclusion: The grayscale harmonic CEUS can effectively and completely observe and evaluate the perfusion characteristics of neovascularization in carotid atherosclerotic plaque and accurately evaluate the information of plaque neovascularization, which is important for the prevention and treatment of unstable atherosclerotic plaques in the future Data reference, increase the comprehensiveness and accuracy of the treatment plan.