Color Doppler ultrasound diagnosis of carotid atherosclerosis and its clinical value analysis methods
【Abstract】 Objective To evaluate the color Doppler ultrasound hypertension, cerebrovascular disease, diabetes, carotid artery atherosclerosis in patients with the
characteristics and application value. Methods Color Doppler ultrasonography in 96 cases of hypertension, cerebrovascular disease, and diabetes in patients with carotid artery test, and the results were analyzed retrospectively. Results Of the 40 patients
with hypertensive patients, 32 patients with different degrees of carotid artery plaque formation, the incidence rate of 80%; 32 cases of cerebral vascular disease patients, 21 patients with different degrees of carotid artery plaque formation, the incidence rate of
66 %; 18 cases of diabetes combined with hypertension in diabetic patients, 13 patients with different degrees of carotid artery plaque formation, the incidence rate of 72%; six cases of diabetes, two cases have different degrees of carotid artery plaque
formation, incidence of 33%. Conclusion hypertension, cerebrovascular disease, diabetes mellitus patients with multiple secondary to carotid artery atherosclerotic plaque; the use of color Doppler ultrasound can be accurate and effective evaluation of
the extent of carotid artery disease; for the effective prevention and treatment of senile vascular lesions provide a basis for of great significance.
Key words Color Doppler ultrasound of carotid atherosclerotic plaque
Abstract: Objective: To evaluate the application of color doppler ultrasound for the arteria carotis scleratheroma detection among hyperpiesia, cerebral vessels and diabetes diseases. Methods: The arteria carotis was detected by color Doppler ultrasound among 96 cases of hyperpiesia, cerebral vessels and diabetes diseases. Result: Among 40 cases of hyperpiesia, there are 32 cases with arteria carotis atherogenesis in different extent, and its incidence is 80%; Among 32 cases of cerebral vessels diseases: Twenty-one cases had arteria carotis atherogenesis, and its
incidencewas 66%. Among 18 cases of diabetes complicated with hyperpiesia, 13 cases had arteria carotis atherogenesis, and its incidence was 72%; Among 6 cases of diabetes, 2 cases had arteria carotis atherogenesis, and its incidence was 33%.
Conclusion: Atherosclerotic plaque can be found in most hyperpiesia, cerebral vessels and diabetes diseases; Arteria carotis diseases can be evaluated exactly by Color Doppler ultrasound, which effectively supports the prevention and treatment of
peripheral vascular diseases.
Key words: color Doppler ultrasound; carotis; atherosclerotic plaque
Elderly carotid artery atherosclerosis in the high incidence of hypertension, cerebrovascular disease, a higher incidence of diabetes. With the development of ultrasound technology, color Doppler ultrasound on the internal carotid artery - the
intima-media thickness and plaque formation and vascular changes in blood flow dynamics can be detected more clearly on the early diagnosis of carotid artery
atherosclerosis provides a reliable basis. In this study, color Doppler ultrasound for high blood pressure, cerebrovascular disease, diabetes mellitus in patients with carotid artery atherosclerosis in Ultrasonography and hemodynamic changes was analyzed,
are reported as follows.
1 Data and methods
1.1 The object of study
96 cases of high blood pressure, cerebral blood vessels, diabetic patients were during the period 2002 to 2006 patients in our hospital. 61 patients were male and
female 35 cases, older than 60 years of age; 40 cases of patients with hypertension, cerebrovascular disease and 32 patients, 24 patients with diabetes.
1.2 Instruments and methods
Instruments used GE LOGIQ7 type, GE VIVID7-mode color Doppler ultrasonic
diagnostic apparatus, the probe frequency of 10MHz. Patient was supine, head thrown back a little biased towards the opposite side checks carried out longitudinal and cross-
section testing, were measured common carotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA), common carotid artery bifurcation Division (BIF), in - media thickness (IMT), peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI), and observe whether the carotid artery plaque and plaque The location, shape, size and echo characteristics and hemodynamic changes.
96 cases in this group of patients, 58 patients with different degrees of carotid artery plaque formation, occurrence rate of 60%, were male and 41 cases, female 17 cases; patch distribution to BIF at a maximum; mild stenosis, 39 cases of degree of stenosis in 13 cases, 4 cases of severe stenosis, arterial occlusion in 2 cases.
Color Doppler ultrasonography is as follows: (1) Two-dimensional ultrasound
images: a normal carotid artery intima smooth, the middle of the dark zone, thickness uniformity, high membrane was bright echo zone, common carotid artery IMT is less than 1.0 mm; carotid artery atherosclerosis, the intimal thickening uneven, rough, when the IBM1.0 mm  or partial diagnosis of carotid atherosclerosis with plaque who, when IMT1.2 mm or for the value of adjacent parts of IMT 1.5-fold or more ,
diagnosis of atherosclerotic plaque formation, single or multiple. Ultrasound plaque type: Flat spot: an early fatty streak deposit in the intima, local uplift or a diffuse thickening, audio-visual picture shows the endometrium is not structured, showing a uniform low-echo. Soft spot: In order to fibrous tissue proliferation and calcium
deposition, plaque hemorrhage, thrombosis, manifested broke into the lumen of the mixed or weak echo echo type, plaque smooth surface. Morphea: plaque sclerosis, echo a strong acoustic shadow behind a clear or sound attenuation, but the relatively smooth surface plaque. Ulcer plaque: Plaque surface smooth, irregular shape, and sometimes showed niche-like images, ulcer edge of the lower echo. (2) color Doppler performance: mild carotid atherosclerosis who showed color Doppler beam is only around the rough; plaques occur within the lumen, the regional blood flow filling defect; appears narrow, the blood-beam changes in small and narrow in a narrow post-office color mosaic
showing the blood flow signal; completely occluded by the occlusion of the lumen without flow signal segment, near the upper end of occlusion to reduce blood flow velocity, and there will be counter-current or eddy current. (3) Spectral Doppler
performance: mild stenosis of the carotid artery band slightly widened, the peak flow
velocity had no significant change or slightly accelerated. Showed moderate or severe stenosis spectrum filling, peak and end-diastolic velocity accelerated; narrow spectrum
low-lying distal blood flow expressed as peak flow rate to reduce and speed up longer. Severe stenosis of the proximal vascular resistance increased. Cavity can elicit segmental artery occlusion Doppler spectrum. When the internal carotid artery occlusion, the ipsilateral common carotid artery spectrum showed high resistance type,
only a small amount of diastolic blood flow or no blood flow, or even reverse wave, contralateral carotid artery flow velocity increase can be compensated.
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Atherosclerotic plaque formation is a distinctive feature of atherosclerosis, mainly arterial intimal lipids, complex carbohydrates and blood content of the stove-like
accumulation of smooth muscle cell proliferation, collagen fiber proliferation,
accompanied by necrosis and calcification of the pathology change, and in the Department of aortic bifurcation and the initial high incidence of plaque, in addition to lipid metabolism disorders and arterial wall dysfunction is caused by atherosclerotic
plaque reasons, due to local vascular expansion, the formation of vortex flow region , to reduce the flow velocity is also an important factor in the formation of plaque. Therefore, the low shear strength, low-velocity blood flow dynamics is characterized by
an important factor in the formation of plaque.
The results of this study show that: hypertension, cerebrovascular disease, diabetes, carotid artery in patients with varying degrees most of the atherosclerotic plaque formation, especially hypertension, cerebral vascular disease in patients with obvious, they are caused by carotid artery atherosclerotic plaques in the main factor. This study showed that carotid atherosclerotic plaque predilection sites in order to BIF
is most prevalent, often involving both sides, followed by the CCA Office, ICA, and ECA rare. Hypertension, cerebrovascular disease, diabetes and other systemic disease was secondary to morphological changes of the neck blood vessels, the early changes in
the performance of these diseases in the neck blood vessels, mainly for the arterial intimal thickening, plaque formation, thrombosis and stenosis occlusion. Therefore, these diseases, the risk factors for atherosclerotic plaque formation provides a pathological basis.
Carotid artery is an important pathway of brain blood flow, carotid artery and intracranial blood supply have a direct correlation, while the extracranial carotid artery vascular disease accounted for 2 / 3. Carotid atherosclerotic plaque, especially
the soft spot, after the formation of plaque ulceration, if there is plaque rupture, hemorrhage, thrombosis, and emboli shedding is the main reason leading to cerebral
infarction. The clinical symptoms caused by atherosclerotic plaque degree of stenosis is
closely related: those with mild stenosis may be asymptomatic; stenosis may appear obvious transient ischemic attack, causing the blood supply of the brain barriers, the onset of a sudden, short-lived, appears at the side of limb weakness or numbness may
also experience short-term nature of language difficulty. Carotid atherosclerotic plaque characteristics and clinical ultrasound morphology between closely related: generally hypoechoic plaques of unstable plaque, lipid and more fibrous cap is thin, fragile, easily
broken bleeding, thrombosis, consequent shedding caused by cerebral infarction; a hard spot to stabilize the plaque, plaque lipid less thick fibrous cap integrity, surface calcification, should not be broken, less cause cardio-cerebral vascular accident .
In conclusion, color Doppler ultrasound examination of carotid atherosclerosis is a simple, non-invasive, safe and economical method of checking, it can be carried out on the plaque morphology evaluation, and can estimate its stability, in order to
effectively prevention and treatment of senile vascular lesions to provide a basis, it is of great significance.
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