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目的探讨纵切面、横切面两种超声造影方法评价颈动脉粥样硬化斑块性质的临床价值。方法颈动脉粥样硬化伴斑块形成患者40例,47个斑块,分别通过纵切面、横切面两种切面方法超声造影分析斑块内增强程度及斑块面积、最大厚度,探讨两种超声造影方法的临床价值。结果 47个斑块中43个斑块超声造影表现为增强。纵切面超声造影显示斑块内增强程度:Ⅰ级4个、Ⅱ级11个、Ⅲ级19个、Ⅳ级5个。在纵切面超声造影基础上结合横切面超声造影后,斑块内增强程度显示为Ⅰ级4个、Ⅱ级11个、Ⅲ级21个、Ⅳ级10个。其中斑块增强程度从Ⅱ级提高为Ⅲ级3个(6.4%),斑块增强程度从Ⅲ级提高为Ⅳ级5个(10.6%)。超声造影时纵切面和横切面两种方法对颈动脉斑块的评价一致性较好(Kappa=0.743,P<0.05)。结论颈动脉粥样硬化斑块超声造影时纵切和横切两种切面可从不同角度反映斑块性质,但两种切面方法相结合有助于更好地反映斑块内新生血管形成及斑块形态学特征,具有更高的临床价值。
Objective To investigate the clinical value of two kinds of contrast-enhanced ultrasound and transverse sections in evaluating carotid atherosclerotic plaque. Methods Forty cases and 47 plaques of carotid atherosclerosis plaque were divided into two groups by longitudinal section and transverse section respectively. Contrast enhancement and plaque area, The clinical value of radiographic methods. Results Forty-three of the 47 plaques showed enhanced contrast-enhanced ultrasound. Longitudinal contrast echocardiography showed plaque enhancement: 4 in grade Ⅰ, 11 in grade Ⅱ, 19 in grade Ⅲ and 5 in grade Ⅳ. On the basis of longitudinal contrast-enhanced ultrasound combined with transthoracic echocardiography, there were 4 grade Ⅰ, 11 grade Ⅱ, 21 grade Ⅲ and 10 grade Ⅳ in plaque. The degree of plaque enhancement increased from Ⅱ to Ⅲ (6.4%), and the plaque enhancement increased from Ⅲ to 5 (Ⅳ) (10.6%). The contrast between longitudinal and transverse sections of carotid artery plaque evaluated by ultrasound contrast was better (Kappa = 0.743, P <0.05). Conclusions Both longitudinal and transverse sections of carotid atherosclerotic plaques can reflect plaque properties from different angles. However, the combination of the two sections helps to better reflect the formation of plaque neovascularization and plaque Block morphological characteristics, with higher clinical value.