脑梗死患者颈动脉粥样硬化斑块的超声影像评价

发布时间：2018-04-02 16:48

本文选题：超声造影检查　切入点：颈动脉疾病　出处：《内蒙古大学》2014年硕士论文

【摘要】：目的：应用彩色多普勒超声(colour doppler ultrasonic, CDUS)和超声造影(Contrast-Enhanced Ultrasound, CEUS)检测颈动脉内膜斑块在脑梗死患者组和非梗死组的声学图像特性和新生血管特点及差异,为阐明颈动脉内膜斑块与脑梗死的发生之间的关系提供依据,以期为预警脑卒中提供手段。方法：1、选择2012年1月至2013年10月在包钢医院住院的新发经头颅计算机断层扫描(computed tomography, CT)或磁共振成像(magnetic resonance imaging, MRI)证实为脑梗死患者56例作为脑梗死组,超声检查均有颈动脉斑块形成；选择同期行颈部血管超声检查发现有颈动脉斑块,其中CT或MRI证实无脑梗死的患者52例作为对照组。2、应用CDUS检测两组的颈动脉狭窄程度,测量颈动脉内中膜厚度(intima-media thickness, IMT),观察斑块的声学特征(大小、形态、回声强弱等)。3、应用CEUS观察斑块的新生血管及造影增强强度等。4、通过声学定量分析Acoustic quantification analysis软件在机分析,并进行组间比较。结果：1、CDUS能获得清晰的颈动脉病变声像图,依据回声将斑块区分为软斑(低回声)及硬斑(强回声),测定准确的颈动脉病变检查指标(血管狭窄及IMT程度)。2、CEUS可显示斑块的新生血管,测量斑块的增强情况(造影增强分级及造影增强强度)。3、通过比较分析,脑梗死组的中、重度狭窄率(70%)均高于对照组,有统计学意义。4、脑梗死组的IMT增厚发生率及软斑(低回声斑块)检出率均高于对照组,差异有统计学意义。5、脑梗死组斑块的造影增强分级及增强强度等指标均高于对照组,有统计学意义。结论：CDUS适用于对高危人群早期、广泛性的临床筛查应用,CEUS可实时观察颈动脉斑块内新生血管情况,评估斑块的易损性,斑块的声学特点及增强特征与脑梗死关系密切,可以作为有效监测指标。
[Abstract]:Objective: to investigate the acoustic and angiogenic characteristics of carotid intima plaques in cerebral infarction patients and non-infarction patients by color Doppler doppler ultrasound (CDUSS) and contrast-enhanced ultrasound (CEUSS).To elucidate the relationship between carotid intimal plaque and cerebral infarction, and to provide a means for early warning of stroke.Methods from January 2012 to October 2013, 56 newly diagnosed patients with cerebral infarction were selected as cerebral infarction group, who were admitted to Baogang Hospital from January 2012 to October 2013 by computed tomography (CTI) or magnetic resonance resonance imaging (MRI).Carotid plaques were detected by ultrasonography, carotid plaques were found in the same period, 52 patients with no cerebral infarction confirmed by CT or MRI were used as control group. The degree of carotid artery stenosis was detected by CDUS.Carotid intima-media thicknesswas measured. The acoustical characteristics (size, morphology, echo intensity, etc.) of plaque were observed. The angiogenesis and enhancement intensity of plaque were observed by CEUS. The results were analyzed by Acoustic quantification analysis software.The comparison between groups was carried out.Results the sonogram of carotid artery lesions could be clearly obtained by CDUS.The plaques were divided into soft (hypoechoic) and hard (hyperechoic) plaques according to the echo. The accurate examination indexes of carotid artery lesions (vascular stenosis and degree of IMT) could be used to display the new vessels of the plaques.The enhancement of plaques (contrast enhancement grade and intensity of contrast enhancement were measured. By comparison and analysis, the moderate and severe stenosis rate of cerebral infarction group was higher than that of control group).The incidence of IMT thickening and the detection rate of soft plaque (hypoechoic plaque) in the cerebral infarction group were higher than those in the control group (P < 0.05). The contrast enhancement grade and intensity of the plaque in the cerebral infarction group were higher than those in the control group.There is statistical significance.Conclusion the use of CEUs is suitable for early clinical screening of high-risk population. CEUs can be used to observe the status of intracarotid plaque neovascularization in real time and to evaluate the vulnerability of plaque. The acoustic characteristics and enhanced features of plaque are closely related to cerebral infarction.It can be used as an effective monitoring indicator.
【学位授予单位】：内蒙古大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.33

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