三维超声血流向量成像联合Essen评分对颈动脉易损斑块的诊断价值研究

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【Abstract】 Objective To explore the diagnostic value of three-dimensional ultrasound flow vector imaging combined with Esen strokerisk score incarotid vulnerable plaques，andto provide anew evaluation strategy for the precise prevention of ischemic stroke.MethodsA single center retrospective cohort study was conducted to include patients with carotid artery plaques who visited our hospitalfrom December 2022 to December 2024.The patients were divided into a vulnerable plaque group of 52 cases and a stable plaque group of 38 cases. Hemodynamic parameters of plaques [peak blood flow velocity（Vpeak）， wallshear stress（WSS）] werecollected by three-dimensional ultrasound flow vector imaging，and stroke risk was evaluated usingthe Esen score.Highresolution magnetic resonance vessel wallimaging （HR-MRI） combined with ischemic stroke/TIA events within 6 monthsservedas thegold standard for vulnerable plaques.Differences，correlations，and diagnosticefficacy of hemodynamic parametersand Esen scores between the two groups were analyzed using Spearman correlation analysis，multivariate logistic regression，and ROC curve.ResultsVpeak[（81.83 ± 13.25）cm/s vs. （103.18±11.68） cm/s]and WSS[（0.81±0.21）Pavs. （1.35±0.23）Pa] inthe vulnerable plaque group were significantlylower than those in the stable plaque group （all P<0.001 ），while the Essen score[6.00（5.00，7.00）score vs. 2.00（1.00，4.00）score] was significantly higher（ P<0.001 ）.Vpeak（ r=-0.455 ）andWSS（ r= -0.545） were negatively correlated with the Essen score （all P <0.001）.Multivariate logisticregressonshowed that Vpeak，WSS，and Essen scorewere independent predictors of vulnerable plaques （all P<0.001 ）.TheAUC of the combined diagnosis of Vpeak，WSS，and Essen scoreswas O.997，witha sensitivityof 98.10% and a specificity of 97.40% ，significantlybetter than the single diagnosis of Essen score （Z=2.O25，P=0.0o2）.ConclusionThree-dimensional ultrasound flow vector imaging combined with Essen score can significantlyimprove the diagnostic eficacyof carotid vulnerable plaques，providing animaging-clinical combined evaluation tool for early warning of ischemic stroke.

【Key Words】 Ultrasonography，Doppler; Stroke; Atherosclerotic plaque; Carotid artery; Essen scoreDOI：10.19522/j.cnki.1671-5098.2025.11.009

缺血性脑卒中作为全球致死、致残率最高的疾病之一，其病死率达 30% 约 70% 生存者存在不同程度功能障碍，严重威胁人类健康。（剩余10110字）