斑块内新生血管分布特征的超声造影与病理对照

发布时间：2018-05-25 02:23

本文选题：颈动脉 + 动脉粥样硬化　；参考：《中国医学影像技术》2015年05期

【摘要】：目的探讨症状性颈动脉内膜剥脱术(CEA)患者颈动脉杈斑块内新生血管分布情况,并与病理对照分析。方法对27例拟行CEA(CEA组)患者和25例无症状性颈动脉斑块形成患者(对照组)行CEUS检查。观察两组斑块增强分布特征。对CEA患者术后标本行组织病理检查。结果 CEA组3例无增强;24例增强,其中20例(20/24,83.33%)基底部、中部及近内膜均增强,4例(4/24,16.67%)基底部和(或)中部增强,而内膜处无增强;对照组9例无增强,16例增强,其中4例(4/16,25.00%)基底、中部及近内膜处均增强,12例(12/16,75.00%)基底部和(或)中部增强,而近内膜处无增强,CEA组斑块近内膜处增强发生率(20/27,74.07%)明显高于对照组(4/16,25.00%;χ2=13.61,P0.01);两组斑块基底部及中部增强率比较,差异无统计学意义(P0.05)。病理结果显示CEA组斑块不同节段(近心段、中段及远心段)的基底部、中部、近内膜处均可见新生血管。结论颈动脉斑块CEUS可评价斑块内新生血管分布情况,近内膜处出现新生血管高度提示斑块不稳定。
[Abstract]:Objective to investigate the distribution of neovascularization in carotid artery branched plaques in patients with symptomatic carotid endarterectomy. Methods CEUS was performed in 27 patients with CEA(CEA and 25 patients with asymptomatic carotid plaque formation (control group). The distribution characteristics of plaque enhancement in two groups were observed. Histopathological examination was performed on the postoperative specimens of patients with CEA. Results in the CEA group, no enhancement was found in 24 cases, including 20 cases with 20% 24 / 24% 83.33) basal base, 4 cases with 4 / 24% 24% 16. 67% enhancement at the base and / or middle part of the base, but no enhancement in the intima, while 9 cases in the control group showed no enhancement in 16 cases, including 4 cases 4 / 1625. 00). There were 12 / 12 / 1675.00 / 12 / 12 / 16 / 75.00 / 12 / 12 / 12 / 12 / 12 / 12 / 12 / 12 / 12 / 25. 00) basal and / or mid-basal enhancement, while 20 / 2774.07 in the non-enhanced CEA group were significantly higher than those in the control group (4 / 16 / 25. 00; 蠂 2 / 13. 61, P 0. 01; the basal and central plaques enhancement rates were higher than those in the control group, respectively), and there was no significant difference between the two groups (P < 0. 05). The difference was not statistically significant (P 0.05). Pathological results showed that neovascularization could be seen in the base, middle and proximal intima of different segments of plaque (proximal, middle and distal) in CEA group. Conclusion CEUS can be used to evaluate the distribution of neovascularization in carotid plaques, and the appearance of neovascularization near the intima suggests that the plaque is unstable.
【作者单位】：首都医科大学附属北京天坛医院超声科;
【分类号】：R743.3;R445.1

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