首页|颈部超声弹性成像联合超声造影对脑梗死颈动脉粥样硬化的诊断价值分析

颈部超声弹性成像联合超声造影对脑梗死颈动脉粥样硬化的诊断价值分析

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目的 探讨颈部超声弹性成像联合超声造影对脑梗死颈动脉粥样硬化(CAS)的诊断价值。方法 选取 2021年 10 月至 2022 年 10 月郑州市第七人民医院收治的 320 例脑梗死患者均进行常规超声、颈部超声弹性成像、超声造影检查,以数字减影血管造影为金标准,比较斑块检出率、稳定性与不稳定性、斑块检查参数及诊断价值。结果 320 例脑梗死患者中共检出CAS斑块 251 例(78。44%);颈部超声弹性成像联合超声造影对CAS斑块检出率(98。41%)高于常规超声(87。65%)、颈部超声弹性(94。42%)、超声造影(94。82%);颈部超声弹性成像联合超声造影和超声造影对软斑块检出率(98。11%、95。60%)高于常规超声和颈部超声弹性成像(86。16%、89。31%);颈部超声弹性成像联合超声造影对硬斑块检出率(97。22%)显著高于常规超声(77。78%);稳定性斑块组斑块厚度、弹性评分、增强密度均小于不稳定性斑块组;斑块厚度、弹性评分、增强密度单项及联合诊断脑梗死CAS不稳定性斑块的AUC分别为 0。888、0。973、0。774、0。995,发现联合诊断的敏感度、特异度较高,差异有统计学意义(P<0。05)。结论 常规超声、颈部超声弹性成像、超声造影均可诊断脑梗死CAS,同时其检查参数斑块厚度、弹性评分、增强密度可有效评估脑梗死CAS斑块稳定性,联合诊断价值更高。
Diagnostic Value of Cervical Ultrasound Elastography Combined with Contrast-enhanced Ultrasound for Carotid Atherosclerosis in Cerebral Infarction
Objective To evaluate the diagnostic value of cervical ultrasound elastography combined with contrast-enhanced ultrasound in carotid atherosclerosis(CAS)in cerebral infarction.Methods A total of 320 patients with cerebral infarction admitted to the Seventh People's Hospital of Zhengzhou from October 2021 to October 2022 were selected for routine ultrasound,neck ultrasound elastography,and contra-ultrasound examination,with digital subtraction angiography as the gold standard.The plaque detection rate,stability and instability,plaque detection parameters,and diagnostic value were compared.Results A total of 251 CAS plaques(78.44%)were detected in 320 patients with cerebral infarction.The detection rate of CAS plaque by neck ultrasound elastography combined with contrast-enhanced ultrasound(98.41%)was higher than that by conventional ultrasound(87.65%),neck ultrasound elastography(94.42%),and contrast-enhanced ultrasound(94.82%).The detection rate of soft plaque of cervical ultrasound elastography combined with contrast-enhanced ultrasound and contrast-enhanced ultrasound(98.11%,95.60%)was higher than that of conventional ultrasound and cervical ultrasound elastography(86.16%,89.31%).The detection rate of neck ultrasound elastography combined with contrast-enhanced ultrasound(97.22%)was significantly higher than that of conventional ultrasound(77.78%).The patch thickness,elasticity score,and enhancement density of the stable patch group were lower than those of the unstable patch group.The AUC of plaque thickness,elasticity score,and enhancement density for single and combined diagnosis of CAS unstable plaques in cerebral infarction were 0.888,0.973,0.774,and 0.995,respectively,indicating that the sensitivity and specificity of combined diagnosis were higher,and the difference was statistically significant(P<0.05).Conclusion Conventional ultrasound,neck ultrasound elastic imaging and contrast ultrasound can diagnose CAS in cerebral infarction.Meanwhile,plaque thickness,elastic score,and enhanced density can effectively evaluate the stability of CAS plaques in cerebral infarction,and the combined diagnosis value is higher.

cerebral infarctioncarotid atherosclerosisneck ultrasound elastographycontrast ultrasound

崔前辉、郭元勋、杨帆、袁国胜

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郑州市第七人民医院 超声科,河南 郑州 450000

郑州市第七人民医院 超声影像科,河南 郑州 450000

脑梗死 颈动脉粥样硬化 颈部超声弹性成像 超声造影

2024

临床研究
西安交通大学

临床研究

影响因子:0.234
ISSN:2096-1278
年,卷(期):2024.32(1)
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