| Objective:Comparative analysis of the accuracy and feasibility of carotid arterial elasticity ultrasound(CDUS),CT vascular function imaging(CTA),and magnetic resonance black blood technology(BB-MRI)in the diagnosis of carotid atherosclerotic plaque stability.Comparing the pathological results to analyze the diagnostic value of CTA and BB-MRI on carotid atherosclerotic plaque tissue structure before surgery,and provide a theoretical basis for the selection of surgical treatment for clinical carotid stenosis patients.Methods:Retrospectively select patients undergoing CEA surgery in the Affiliated Hospital of Chengde Medical College from October 2018 to February 2021,and collect preoperative BB-MRI,CTA,CDUS results and pathological results.Determine the stability of the plaque according to the inspection results,analyze and compare the consistency of each inspection result with the pathological results.Statistical software was used SPSS19.0 analyze the data,and the paired counting data were used to calculate the P value by paired chi-square test and exact probability method(Extra high 20% cell horizon <5.00).The test level was p=0.05.If the result is consistent,the consistency degree Kappa consistency coefficient are given.The diagnostic evaluation was analyzed by four-lattice diagnostic test.Results:There were 41 cases with complete imaging and pathological results,31 men and 10 women,aged 50-73.31 cases(75.6%)of unstable plaques and 10 cases(24.4%)of stable plaques were detected pathologically.Ultrasound showed 24 soft plaques(58.5%)and stable plaques 17(41.5%).CT vascular imaging detected 24 vulnerable plaques(58.5%)and stable plaques 17(41.5%).Black blood nuclear magnetic examination revealed that vulnerable plaques were 30(73.2%)and stable plaques 11(26.8%)had the highest detection rate.Taking pathological results as the gold standard,CDUS has a significant d ifference in the detection rate of vulnerable plaques in patients(p=0.028,p<0.05);CTA has statistical significance in the detection rate of vulnerable plaque s in patients(p=0.270),p>0.05);Kappa is 0.198.There was no significant d ifference in the detection rate of vulnerable plaque between BB-MRI and path ology(p=0.098,p>0.05);Kappa was 0.296.Describe and evaluate the three ins pection methods,the sensitivity is: CDUS(48.7%),CTA(64.5%),BB-MRI(80.6%),specificity: CDUS(10.0%),CTA(60.0%),BB-MRI(50.0%)positive predictive value CDUS(62.5%),CTA(83.3%),BB-MRI(83.3%).The negativ e predictive value is CDUS(5.8%),CTA(35.3%),BB-MRI(45.4%),and the accuracy is CDUS(39.0%),CTA(65.4%),BB-MRI(73.0%).4.Pathologically detected 15 lipid-rich core plaques,21 ulcer-ruptured plaques,21 thin fibrous cap plaques,and 18 under-plaque hemorrhages.BB-MRI detected 18lipid-rich core plaques.19 ulcer-ruptured plaques,22 thin-fiber cap plaques,24under-plaque hemorrhages,19 lipid-rich core plaques detected by CTA,15ulcer-ruptured plaques,and thin fiber cap plaques 11,9 of them were bleeding under the plaque.Comparison of detection results: BB-MRI and pathology showed no significant difference in the detection of the four plaques and pathology(p>0.05).CTA was related to pathology in lipid-rich core plaques and ulcerated ruptured plaques It is consistent(p>0.05),and there is a statistically significant difference in the detection of thin fiber cap plaque and bleeding under the plaque(p<0.05).Conclusion:BB-MRI contrast CTA and CDUS have high sensitivity and accuracy in the diagnosis of unstable carotid plaque,and the consistency is CTA high,which has certain clinical reference value.BB-MRI has good consistency in the detection of various unstable intimal plaques,and has guiding significance for the surgical selection and standardized diagnosis and treatment of patients with clinical carotid artery stenosis,especially asymptomatic patients. |
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