【摘要】 目的对比分析颈动脉超声、CT血管显像(CT angiography,CTA)、磁共振成像(magnetic resonance imaging,MRI)对颈动脉粥样硬化斑块性质的诊断价值。方法收集55例接受颈动脉内膜剥脱术治疗的颈动脉粥样硬化斑块患者的斑块组织,将55例粥样硬化斑块行常规HE切片及免疫组织化学染色,标记CD31、CD34以及FⅧ抗体,分析斑块中各种成分并判断斑块稳定性,并将斑块的相关病理表现进行分类。同时收集55例患者术前颈动脉超声、CTA及MRI对斑块性质成分的诊断结果,并以病理诊断结果为金标准,对颈动脉超声、CTA及MRI进行评价。结果颈动脉超声与病理检查出易损斑块的检出率差异无统计学意义(P>0.05);CTA与病理检出率差异有统计学意义(P<0.05);MRI与病理检出率差异无统计学意义(P>0.05);敏感度MRI>颈动脉超声>CTA。结论颈动脉粥样硬化斑块患者采用颈动脉超声及MRI可以对斑块易损性作出比较明确的判断,且MRI敏感度更高。更多还原

【Abstract】 Objective To compare and analyze the diagnostic value of carotid ultrasound, CT angiography(CTA) and magnetic resonance imaging(MRI) in the diagnosis of carotid atherosclerosis plaque. Methods The plaque tissues of 55 patients with carotid atherosclerosis plaque treated by carotid endarterectomy(CEA) were collected. Fifty-five atherosclerosis plaques were routinely sliced by HE and immunohistochemical staining, labeling CD31, CD34 and FⅧ antibodies were used to analyze various components in the plaque and to determine plaque stability, and to classify the relevant pathological features of the plaque. At the same time, the results of preoperative carotid ultrasound, CTA and MRI on the plaque properties were collected from 55 patients, and the pathological diagnosis was compared with gold standard. Results There was no significant difference in the detection rate of vulnerable plaques between carotid ultrasound and pathology(P>0.05). There was significant difference in the detection rate of vulnerable plaques between CTA and pathology(P<0.05).There was no significant difference in the detection rate of vulnerable plaques between MRI and pathology(P>0.05),and sensitivity of MRI>carotid ultrasound>CTA. Conclusion Carotid ultrasound and MRI can be used to evaluate the vulnerability of plaque in patients with carotid atherosclerosis plaque,and the sensitivity of MRI is higher.更多还原