超声声学造影评价颈动脉粥样硬化斑块新生血管形成及稳定性.ppt

* Correlation of Carotid Plaque Neovascularization Detected by Contrast-Enhanced Ultrasound Imaging With Clinical Symptoms You-Bin Deng, MD, 邓又斌 Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China 武汉同济医院 Mechanisms of vessel wall neovascularization in atherosclerosis Doyle B et al. JACC 2007; 49:2073 Possible roles for microvessels in disease progression include the supply of cellular and soluble lesion components, enhancement of intraplaque gas exchange, and delivery of metabolic substrates to the plaque core. Doyle B et al. JACC 2007; 49:2073 Neovascularization in Stable and Unstable Coronary Plaques Kolodgie FD et al. JACC 2007;49:2093 Plaque neovascularization and clinical symptoms Fleiner M et al. Circulation 2004;110:2843 Number of microvessels identified from plaques of symptomatic and asymptomatic patients. McCarthy MJ et al. J Vasc Surg 1999;30:261 Vessel Density at Histology According to Plaque Contrast-Agent Enhancement Coli S et al. JACC 2008;52:223 Vulnerable patients have vulnerable plaques Plaque neovascularization is the remarkably consistent feature of vulnerable plaque in cerebrovascular patients Contrast-enhanced carotid ultrasound imaging is promising and may serve to detect the neovascularization within the atherosclerotic plaque in vivo. Carotid plaque contrast-agent enhancement with sonographic agent correlates with histological density of neovessels within the carotid plaque The association between the carotid plaque enhancement with contrast agent microbubbles and clinical symptoms is not fully understood. Study Population 研究方法 GE Log9超声诊断仪 9L探头：频率为6MHz 机械指数：0.13 104例患者 快速静脉注射SonoVue 1.5 ml 实时观察颈动脉腔及斑块内造影剂显影情况 Grade 1: no enhancement within the plaque or enhancement confined to plaque adventitial side and/or shoulder Grade 2: enhancement reaching plaque core/or extensive contrast agent enhancement throughout the plaque. Grading of Contrast-Agent Enhancement by Visual Interpretation Grading of Co