摘要目的:应用超声造影定性和定量分析评估颈动脉斑块新生血管稳定性，探讨其与缺血性脑卒中发生的相关性。方法:选取海盐县人民医院2017年8月至2019年12月常规超声检查诊断为颈动脉斑块患者100例为观察对象，根据卒中发生情况分为缺血性脑卒中组60例，非缺血性脑卒中组40例。对两组患者颈动脉进行超声造影检查（contrast-enhanced ultrasound，CEUS），利用软件定量分析斑块内新生血管稳定性及其与缺血性脑卒中发生的关系。结果:全组患者常规超声检查颈动脉斑块回声为低回声或者中等回声，两组比较，缺血性脑卒中组患者增强分级中3~4级所占比例较高（ P<0.05）。超声造影显示相对于非缺血性脑卒中组患者，缺血性脑卒中组患者达峰时间（TTP）较短［（25.46±3.25）s比（32.77±4.28）s， t=3.783， P=0.000］、峰值强度（PI）［（59.62±10.18）dB比（47.53±14.36）dB， t=3.263， P=0.000］和曲线下面积（AUC）［（2 365.37±346.03）cm 2比（1 695.42±525.44）cm 2， t=4.981， P=0.000］较高，两组均差异有统计学意义（均 P<0.05）。 结论:应用超声造影增强强度视觉评分结合超声造影量化技术可判断颈动脉斑块稳定性及可能的发展过程，为缺血性脑血管病临床治疗选择合适的时机及制定合理的治疗方案提供切实可靠的依据。

abstractsObjective:To evaluate the stability of newly formed blood vessels in the carotid plaque using qualitative and quantitative analysis of contrast-enhanced ultrasound images and to investigate its correction with the occurrence of ischemic stroke.Methods:A total of 100 patients with carotid artery plaques diagnosed by routine ultrasound who received treatment between August 2017 and December 2019 in Haiyan People's Hospital, China were included in this study. They were divided into an ischemic stroke group ( n = 60) and a non-ischemic stroke group ( n = 40) according to the occurrence of stroke. Two groups of patients underwent contrast-enhanced ultrasound examination of the carotid artery. The correlation between the stability of the newly formed vessels in the carotid plaque and the occurrence of ischemic stroke was quantitatively analyzed. Results:Contrast-enhanced ultrasound results revealed low or medium intensity of echoes. The proportion of patients exhibiting grade 3-4 intensity of echoes in the ischemic stroke group was significantly higher than that in the non-ischemic stroke group ( P < 0.05). Time to peak in the ischemic stroke group was significantly shorter than that in the non-ischemic stroke group [(25.46 ± 3.25) seconds vs. (32.77 ± 4.28) seconds, t = 3.783, P = 0.000]. In the ischemic stroke group, peak intensity [(59.62 ± 10.18) dB vs. (47.53 ± 14.36) dB, t = 3.263, P = 0.000] and the area under the receiver operating characteristic curve [(2 365.37 ± 346.03) cm 2vs. (1 695.42 ± 525.44) cm 2, t = 4.981, P = 0.000] were significantly higher than those in the non-ischemic stroke group (both P < 0.05). Conclusion:Contrast-enhanced ultrasound visual scoring combined with quantitative ultrasonography technology can be used to assess the stability and possible development process of carotid plaques, which provide practical and reliable evidence for selecting a rational opportunity for clinical treatment of ischemic cerebrovascular disease and developing a reasonable treatment plan.