학술논문
三维超声灰阶中位数联合实时微血管超声造影定量评价颈动脉斑块的稳定性 / Three-dimensional ultrasound gray scale median combined with real-time microvascular contrast-enhanced ultrasound in quantitative assessment of carotid plaque stability
Document Type
Academic Journal
Source
血管与腔内血管外科杂志 / Journal of Vascular and Endovascular Surgery. 9(10):1208-1212
Subject
Language
Chinese
ISSN
2096-0646
Abstract
目的 探讨三维超声灰阶中位数(3D-US GSM)联合实时微血管超声造影(CEUS)定量评价颈动脉斑块的稳定性.方法 收集2018年1月至2021年12月海口市人民医院收治的30例存在颈动脉斑块患者的临床资料.测定并分析颈动脉斑块的灰阶中位数(GSM)、实时微血管CEUS的增强强度(EI)、新生血管密度,选取动脉斑块内关键帧及前后各三帧的GSM,根据强回声、等回声、低回声分为钙化组、纤维结缔组织组、脂质坏死核心组,比较3组的GSM,并分析颈动脉斑块内部低回声、等回声GSM与新生血管密度的相关性.以手术病理检查结果为金标准,分析3D-US GSM、实时微血管CEUS及二者联合检查对颈动脉斑块稳定性的诊断效能.结果 经病理检查结果证实,36个颈动脉斑块中,不稳定斑块20个,稳定斑块16个,每平方毫米的平均新生血管密度为(6.62±2.73)条.3组的GSM两两比较,差异均有统计学意义(P﹤0.01).等回声斑块的GSM与斑块内新生血管密度无相关性(r=0.676,P﹥0.05);低回声斑块的GSM与斑块内新生血管密度呈负相关(r=-0.555,P﹤0.05).对于颈动脉斑块的不稳定性,3D-US GSM诊断的准确度为58.33%(21/36),实时微血管CEUS诊断的准确度为61.11%(22/36),二者联合诊断的准确度为80.56%(29/36).结论 应用3D-US GSM和实时微血管CEUS成像技术定量评估颈动脉斑块的稳定性既有优势,又有局限性,而二者联合对颈动脉斑块稳定性的评估灵敏度和特异度更高.
Objective To explore the three-dimensional ultrasound gray scale median(3D-US GSM)combined with real-time microvascular contrast-enhanced ultrasound(CEUS)in quantitative assessment of carotid plaque stability.Method Clinical data of 30 cases patients with carotid plaques admitted in Haikou People's Hospital from January 2018 to December 2021 were collected.The gray scale median(GSM)of carotid plaque,the enhancement intensity(EI)of real-time microvascular CEUS,and the neovascular density were measured and analyzed.According to the high echo,isoecho and hypoecho,the GSM of the key frames and the three frames before and after the key frames were divided into the calcification group,the fibrous connected tissue group,and the lipid necrotic core group,and the GSM of the three groups were compared.The correlation of hypoecho and isoecho GSM with neovascular density within carotid artery plaques was analyzed.The diagnostic efficacy of single and combined detection of 3D-US GSM and real-time microvascular CEUS in carotid plaque stability was analyzed by using surgical pathologic findings as the gold standard.Result The pathological results confirmed that 20 of the 36 carotid plaques were unstable and 16 were stable,and the average neovascular density was(6.62±2.73)/mm2.The pairwise comparison of GSM in the three groups showed statistically significant difference(P<0.01).There was no correlation between GSM of isoecho and neovascular density in carotid plaque(r=0.676,P>0.05).The GSM of hypoecho plaques was negatively correlated with the density of neovascular density in plaques(r=-0.555,P<0.05).For the instability of carotid artery plaques,the accuracy of 3D-US GSM diagnosis was 58.33%(21/36),the accuracy of real-time microvascular CEUS diagnosis was 61.11%(22/36),and the accuracy of combined diagnosis was 80.56%(29/36).Conclusion Both 3D-US GSM and real-time microvascular CEUS quantitative analysis have advantages and limitations in assessing the stability of carotid plaque,but the combined detection have higher sensitivity and specificity in evaluating the stability of carotid plaque.
Objective To explore the three-dimensional ultrasound gray scale median(3D-US GSM)combined with real-time microvascular contrast-enhanced ultrasound(CEUS)in quantitative assessment of carotid plaque stability.Method Clinical data of 30 cases patients with carotid plaques admitted in Haikou People's Hospital from January 2018 to December 2021 were collected.The gray scale median(GSM)of carotid plaque,the enhancement intensity(EI)of real-time microvascular CEUS,and the neovascular density were measured and analyzed.According to the high echo,isoecho and hypoecho,the GSM of the key frames and the three frames before and after the key frames were divided into the calcification group,the fibrous connected tissue group,and the lipid necrotic core group,and the GSM of the three groups were compared.The correlation of hypoecho and isoecho GSM with neovascular density within carotid artery plaques was analyzed.The diagnostic efficacy of single and combined detection of 3D-US GSM and real-time microvascular CEUS in carotid plaque stability was analyzed by using surgical pathologic findings as the gold standard.Result The pathological results confirmed that 20 of the 36 carotid plaques were unstable and 16 were stable,and the average neovascular density was(6.62±2.73)/mm2.The pairwise comparison of GSM in the three groups showed statistically significant difference(P<0.01).There was no correlation between GSM of isoecho and neovascular density in carotid plaque(r=0.676,P>0.05).The GSM of hypoecho plaques was negatively correlated with the density of neovascular density in plaques(r=-0.555,P<0.05).For the instability of carotid artery plaques,the accuracy of 3D-US GSM diagnosis was 58.33%(21/36),the accuracy of real-time microvascular CEUS diagnosis was 61.11%(22/36),and the accuracy of combined diagnosis was 80.56%(29/36).Conclusion Both 3D-US GSM and real-time microvascular CEUS quantitative analysis have advantages and limitations in assessing the stability of carotid plaque,but the combined detection have higher sensitivity and specificity in evaluating the stability of carotid plaque.