【摘要】 目的探讨超微血管成像(SMI)评分预测颈动脉斑块患者发生缺血性卒中的价值。方法选取2016年2月至2018年6月在嘉兴市第二医院就诊且确诊颈动脉斑块的123例患者为研究对象,随访期间发生缺血性卒中28例,未发生缺血性卒中95例。所有患者行SMI和超声造影检查,比较卒中组与非卒中组患者最大斑块厚度、SMI血流评分、增强强度等,分析卒中患者最大斑块SMI血流评分与增强强度的相关性,绘制ROC曲线评估SMI血流评分预测颈动脉斑块患者2年内发生缺血性卒中的效能。结果卒中组患者SMI血流评分、增强强度均明显高于非卒中组,差异均有统计学意义(均P<0.05);两组患者最大斑块厚度比较,差异无统计学意义(P>0.05)。卒中患者最大斑块SMI血流评分与增强强度呈正相关(r=0.786,P<0.05)。SMI血流评分预测颈动脉斑块患者发生缺血性卒中的截断值为2分,AUC、灵敏度、特异度分别为0.836、0.856、0.786。结论 SMI评分能反映颈动脉斑块的新生血管情况,可作为筛查不稳定斑块的无创性检查方法。更多还原

【Abstract】 Objective To evaluate the value of superb microvascular imaging(SMI) score in predicting ischemic stroke in patients with carotid plaque. Methods A total of 123 patients who were diagnosed with carotid plaque in the Second Hospital of Jiaxing from February 2016 to June 2018 were selected. During follow-up, ischemic stroke occurs in28 patients. All patients underwent SMI and contrast-enhanced ultrasound(CEUS), and the maximum plaque thickness,SMI flow score and enhancement intensity(EI) of the largest plaques were compared between the two groups. The correlation between SMI flow score and EI in stroke group was analyzed. ROC curve was plotted to evaluate the efficacy of SMI flow score in predicting ischemic stroke in patients with carotid plaque within 2 years. Results SMI flow score and EI of the stroke group were significantly higher than those of the non-stroke group(all P<0.05), but there was no significant difference in the maximum thickness of carotid plaque between the two groups(P >0.05). The SMI flow score of the largest plaque in the stroke group was positively correlated with EI(r=0.786, P<0.05). The cut-off value of SMI flow score for predicting ischemic stroke in patients with carotid plaque was 2, and the AUC, sensitivity and specificity were 0.836, 0.856 and 0.786, respectively. Conclusion SMI flow score can reflect the neovascularization of carotid plaques, which can be used as a noninvasive method for screening unstable plaques.更多还原