超声造影在颈动脉粥样硬化斑块诊断的临床价值.docVIP

精品论文 参考文献 超声造影在颈动脉粥样硬化斑块诊断的临床价值 龚金玲 孙思 龚思铭 卓忠雄 　　（第三军医大学第二附属医院超声诊断科 重庆 400037） 　　【摘 要】目的：探讨超声造影检查在颈动脉粥样硬化中的临床价值。方法：57例颈动脉粥样硬化斑块患者采用超声造影检查，观察造影前、后颈动脉管腔显示情况、斑块数量、形态特征、斑块内有无血供、评估狭窄程度，并与CTA结果进行对照。结果：超声造影后检出斑块个数（78个）与造影前（56个）比较差异有统计学意义（P〈0．05）；以CTA结果为标准，造影后诊断颈动脉狭窄程度的敏感性（100．0％）、特异性（98．3％）及准确率（97．6％）均明显高于造影前（分别为95．2％，89．2%，90．4％）（P〈0．05）。结论：超声造影诊断颈动脉粥样硬化斑块临床价值明显优于二维超声，可广泛推广应用。 　　【关键词】超声造影；颈动脉粥样硬化；斑块 ；狭窄 　　【中图分类号】R543.4 【文献标识码】A 【文章编号】1004-6194（2015）01-0223-02 　　 The clinical value of contrast enhanced ultrasound in the diagnosis of carotid atherosclerosis plaque 　　GONG Jin-Ling SUN Si GONG Si-Ming ZHUO Zhong-Xiong 　　【Abstract】Objective：To investigate the value of contrast-enhanced ultrasound in the evaluation of carotid atherosclerosis. Methods：Fifty-seven patients with carotid atherosclerosis underwent contrast-enhanced ultrasound. Before and after injection of contrast agent, the carotid lumen was observed, while the amount and the character of the plaques were analyzed, and the stenosis degree was calculated. All results were compared with those of CTA. Results：There was statistically significant difference in the amount of detected plaques （56 vs 78） between before and after injecting contrast agent （P〈0.05）. The sensitivity, specificity and accuracy of the diagnosis of stenosis degree were significantly higher after contrast agent injection on the basis of CTA results （100. 0%, 98. 3%, 97. 6%） as compared with those before contrast agent injection （95.2 %, 89. 2%, 90. 4 %） （P 〈 0. 05）. Conclusion：Contrast-enhanced ultrasound is one of the effective methods for diagnosis of carotid atherosclerosis. 　　【Key words】Contrast-enhanced ultrasound; Carotid Atherosclerosis; Plaques; Stenosis diagnosis; 　　颈动脉粥样硬化（carotid atherosclersis,CAS）是缺血性脑血管病的重要原因，脑卒中多由于颅外段颈动脉粥样硬化病变进行性发展所致【1】，目前，有多种手术方法治疗颈动脉粥样硬化性狭窄，术前应用影像学方法详细了解颈动脉病变部位、范围、狭窄程度、斑块的性质及斑块内有无血供等，对手术的成功尤为重要。二维超声检查是评估筛选颈动脉狭窄的重要手段，但是它通常会高估颈动脉狭窄程度，低回声斑块检出率低，前壁斑块钙化斑影响其后方血流正常显像。本研究探讨超声造影检查在颈动脉粥样硬化斑块中的临床价值。 　　1 资料与方