血管超声在动脉粥样硬化性病变评估中的研究进展
Research Progress of Vascular Ultrasound in the Evaluation of Atherosclerotic Lesions
DOI: 10.12677/acm.2025.154984, PDF,    科研立项经费支持
作者: 王潇婕:重庆医科大学第二临床学院,重庆;孙 阳*:重庆医科大学附属第二医院超声科,重庆
关键词: 血管超声动脉粥样硬化心脑血管疾病Vascular Ultrasound Atherosclerosis Cardiovascular and Cerebrovascular Diseases
摘要: 动脉粥样硬化是一种慢性进展性疾病,主要累及大中型动脉,是心脑血管疾病的重要病理基础,其早期评估对预防心肌梗死、脑卒中等严重并发症至关重要。近年来,血管超声由于其无创、实时、便捷和可重复等优点受到广泛关注,在动脉粥样硬化病变的评估中取得了显著进展。本文结合国内外超声评估动脉粥样硬化性病变的最新研究,探讨了超声在动脉粥样硬化病变中的潜在应用价值,为临床实践和未来研究方向提供参考依据。
Abstract: Atherosclerosis is a chronic progressive disease, which mainly involves large and medium-sized arteries. It is an important pathological basis of cardiovascular and cerebrovascular diseases, and its early evaluation is very important to prevent serious complications such as myocardial infarction and stroke. In recent years, vascular ultrasound has been widely concerned because of its advantages of non-invasive, real-time, convenient and repeatable, and has made remarkable progress in the evaluation of atherosclerotic lesions. This paper discusses the potential application value of ultrasound in atherosclerotic lesions based on the latest research of ultrasound evaluation at home and abroad, and provides reference for clinical practice and future research direction.
文章引用:王潇婕, 孙阳. 血管超声在动脉粥样硬化性病变评估中的研究进展[J]. 临床医学进展, 2025, 15(4): 692-701. https://doi.org/10.12677/acm.2025.154984

参考文献

[1] Zuo, X., Ding, X., Zhang, Y. and Kang, Y.J. (2024) Reversal of Atherosclerosis by Restoration of Vascular Copper Homeostasis. Experimental Biology and Medicine, 249, Article 10185. [Google Scholar] [CrossRef] [PubMed]
[2] Tsao, C.W., Aday, A.W., Almarzooq, Z.I., Alonso, A., Beaton, A.Z., Bittencourt, M.S., et al. (2022) Heart Disease and Stroke Statistics—2022 Update: A Report from the American Heart Association. Circulation, 145, e153-e639. [Google Scholar] [CrossRef] [PubMed]
[3] Nakano, S., Otake, H., Kawamori, H., Toba, T., Sugizaki, Y., Nagasawa, A., et al. (2021) Association between Visit-To-Visit Variability in Low-Density Lipoprotein Cholesterol and Plaque Rupture That Leads to Acute Coronary Syndrome. Circulation Reports, 3, 540-549. [Google Scholar] [CrossRef] [PubMed]
[4] Saladini, F., Rattazzi, M., Faggin, E., Palatini, P. and Puato, M. (2021) Carotid Elasticity Is Impaired in Stage 1 Hypertensive Patients with Well-Controlled Blood Pressure Levels. Journal of Human Hypertension, 36, 898-903. [Google Scholar] [CrossRef] [PubMed]
[5] Zhang, Y., Lacolley, P., Protogerou, A.D. and Safar, M.E. (2020) Arterial Stiffness in Hypertension and Function of Large Arteries. American Journal of Hypertension, 33, 291-296. [Google Scholar] [CrossRef] [PubMed]
[6] Pan, F., Yu, L., Luo, J., Wu, R., Xu, M., Liang, J., et al. (2018) Carotid Artery Stiffness Assessment by Ultrafast Ultrasound Imaging: Feasibility and Potential Influencing Factors. Journal of Ultrasound in Medicine, 37, 2759-2767. [Google Scholar] [CrossRef] [PubMed]
[7] 胡文姝, 徐亮, 周畅. 颈动脉弹性超声检测的临床应用进展[J]. 浙江医学, 2025, 47(2): 208-212.
[8] Wang, Y., Zhao, C., Meng, P., Yu, Y., Li, G., Kong, F., et al. (2020) Incremental Value of Carotid Elasticity Modulus Using Shear Wave Elastography for Identifying Coronary Artery Disease in Patients without Carotid Plaque. Journal of Hypertension, 39, 1210-1220. [Google Scholar] [CrossRef] [PubMed]
[9] Alan, B. and Alan, S. (2022) Evaluation of Carotid Artery Stiffness in Patients with Coronary Artery Disease Using Acoustic Radiation Force Impulse Elastography. Vascular, 31, 564-572. [Google Scholar] [CrossRef] [PubMed]
[10] Tanter, M. and Fink, M. (2014) Ultrafast Imaging in Biomedical Ultrasound. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, 61, 102-119. [Google Scholar] [CrossRef] [PubMed]
[11] Guo, S., Gu, C., Sun, L., Qi, Z. and Wang, B. (2024) Evaluation of Carotid Stiffness in Metabolic Syndrome by Real-Time Shear Wave Elasticity Imaging and Ultrafast Pulse Wave Velocity. Ultrasound in Medicine & Biology, 50, 1280-1286. [Google Scholar] [CrossRef] [PubMed]
[12] Yu, L., Xu, G., Zhou, Q., Ouyang, M., Gao, L. and Zeng, S. (2023) Biomechanical Properties of the Ascending Aorta in Patients with Arterial Hypertension by Velocity Vector Imaging. The International Journal of Cardiovascular Imaging, 40, 397-405. [Google Scholar] [CrossRef] [PubMed]
[13] 王雪婷, 江峰. 二维斑点追踪成像技术评价代谢综合征患者颈动脉弹性的可行性与准确性分析[J]. 九江学院学报(自然科学版), 2024, 39(1): 96-99.
[14] 刘娅, 邝野, 樊华, 等. 超声心动图、颈动脉内膜中层厚度联合N末端脑钠肽前体等指标对川崎病合并冠状动脉病变患儿诊断价值[J]. 临床军医杂志, 2023, 51(12): 1281-1283, 1287.
[15] Raitakari, O.T., Magnussen, C.G., Juonala, M., Kartiosuo, N., Pahkala, K., Rovio, S., et al. (2024) Subclinical Atherosclerosis in Young Adults Predicting Cardiovascular Disease: The Cardiovascular Risk in Young Finns Study. Atherosclerosis, 393, Article ID: 117515. [Google Scholar] [CrossRef] [PubMed]
[16] Zhu, Y., You, J., Xu, C. and Gu, X. (2020) Predictive Value of Carotid Artery Ultrasonography for the Risk of Coronary Artery Disease. Journal of Clinical Ultrasound, 49, 218-226. [Google Scholar] [CrossRef] [PubMed]
[17] Yu, J.B., et al. (2023) Predicting Coronary Artery Disease by Carotid Color Doppler Ultrasonography. European Review for Medical and Pharmacological Sciences, 27, 11713-11721.
[18] Agarwal, R., Gadupati, J., Ramaiah, S.S., Babu, V.G., Jain, A. and Prakash, V.S. (2024) Carotid Artery Doppler: A Possible Non-Invasive Diagnostic Approach to Assessing the Severity of Coronary Artery Disease. Cureus, 16, e62886. [Google Scholar] [CrossRef] [PubMed]
[19] Zhou, P., Shen, Y., Wang, L., Cao, Z., Feng, W., Liu, J., et al. (2020) Association between Carotid Intima Media Thickness and Small Dense Low-Density Lipoprotein Cholesterol in Acute Ischaemic Stroke. Lipids in Health and Disease, 19, Article No. 177. [Google Scholar] [CrossRef] [PubMed]
[20] Ravikanth, R. (2020) Relevance of Carotid Intima-Media Thickness and Plaque Morphology in the Risk Assessment of Patients with Acute Ischemic Cerebral Infarcts: A Case-Control Study of Large Series from a Single Center. Journal of Medical Ultrasound, 28, 29-34. [Google Scholar] [CrossRef] [PubMed]
[21] Porambo, M.E. and DeMarco, J.K. (2020) MR Imaging of Vulnerable Carotid Plaque. Cardiovascular Diagnosis and Therapy, 10, 1019-1031. [Google Scholar] [CrossRef] [PubMed]
[22] Zhang, Y., Cao, J., Zhou, J., Zhang, C., Li, Q., Chen, S., et al. (2021) Plaque Elasticity and Intraplaque Neovascularisation on Carotid Artery Ultrasound: A Comparative Histological Study. European Journal of Vascular and Endovascular Surgery, 62, 358-366. [Google Scholar] [CrossRef] [PubMed]
[23] Zhang, S., Jiang, S., Wang, C. and Han, C. (2023) Comparison of Ultrasonic Shear Wave Elastography, Angioplus Planewave Ultrasensitive Imaging, and Optimized High-Resolution Magnetic Resonance Imaging in Evaluating Carotid Plaque Stability. PeerJ, 11, e16150. [Google Scholar] [CrossRef] [PubMed]
[24] Wang, B., Chen, Y., Qiao, Q., Dong, L., Xiao, C. and Qi, Z. (2023) Evaluation of Carotid Plaque Vulnerability with Different Echoes by Shear Wave Elastography and CEUS. Journal of Stroke and Cerebrovascular Diseases, 32, Article ID: 106941. [Google Scholar] [CrossRef] [PubMed]
[25] 申宜昊, 饶宛婷, 邹葵花, 等. 剪切波弹性成像鉴别不均质颈动脉斑块不同回声区域硬度差异的可行性研究[J]. 中国医学计算机成像杂志, 2022, 28(4): 423-426.
[26] 朱珊, 孙楠, 陶宏宇, 等. 剪切波弹性成像评估颈动脉斑块与冠状动脉病变程度的相关性[J]. 中国医学影像学杂志, 2023, 31(4): 326-331.
[27] Fu, P., Wang, J., Su, Y., Liao, Y., Li, S., Xu, G., et al. (2023) Intravascular Ultrasonography Assisted Carotid Artery Stenting for Treatment of Carotid Stenosis: Two Case Reports. World Journal of Clinical Cases, 11, 7127-7135. [Google Scholar] [CrossRef] [PubMed]
[28] Nasu, K., Tsuchikane, E., Katoh, O., Vince, D.G., Virmani, R., Surmely, J., et al. (2006) Accuracy of in Vivo Coronary Plaque Morphology Assessment: A Validation Study of in Vivo Virtual Histology Compared with in Vitro Histopathology. Journal of the American College of Cardiology, 47, 2405-2412. [Google Scholar] [CrossRef] [PubMed]
[29] Sakurai, S., Takashima, H., Waseda, K., Gosho, M., Kurita, A., Ando, H., et al. (2015) Influence of Plaque Characteristics on Fractional Flow Reserve for Coronary Lesions with Intermediate to Obstructive Stenosis: Insights from Integrated-Backscatter Intravascular Ultrasound Analysis. The International Journal of Cardiovascular Imaging, 31, 1295-1301. [Google Scholar] [CrossRef] [PubMed]
[30] Suzuki, W., et al. (2024) Tissue Characteristics of Residual Lesion in Patients with Acute Coronary Syndrome Caused by Plaque Rupture versus Plaque Erosion: A Single-Center, Retrospective, Observational Study. Nagoya Journal of Medical Science, 86, 189-200.
[31] Czernuszewicz, T.J. and Gallippi, C.M. (2016) On the Feasibility of Quantifying Fibrous Cap Thickness with Acoustic Radiation Force Impulse (ARFI) Ultrasound. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, 63, 1262-1275. [Google Scholar] [CrossRef] [PubMed]
[32] Czernuszewicz, T.J., Homeister, J.W., Caughey, M.C., Wang, Y., Zhu, H., Huang, B.Y., et al. (2017) Performance of Acoustic Radiation Force Impulse Ultrasound Imaging for Carotid Plaque Characterization with Histologic Validation. Journal of Vascular Surgery, 66, 1749-1757.e3. [Google Scholar] [CrossRef] [PubMed]
[33] Torres, G., Czernuszewicz, T.J., Homeister, J.W., Farber, M.A., Caughey, M.C. and Gallippi, C.M. (2020) Carotid Plaque Fibrous Cap Thickness Measurement by ARFI Variance of Acceleration: In Vivo Human Results. IEEE Transactions on Medical Imaging, 39, 4383-4390. [Google Scholar] [CrossRef] [PubMed]
[34] 崔柳平, 周福波, 潘希娟, 等. 血管超声评估颈动脉斑块易损性的研究进展[J]. 中国超声医学杂志, 2024, 40(3): 352-355.
[35] Zhou, F., Hua, Y., Ji, X., Jia, L., Zhang, K., Li, Q., et al. (2021) Ultrasound-Based Carotid Plaque Characteristics Help Predict New Cerebral Ischemic Lesions after Endarterectomy. Ultrasound in Medicine & Biology, 47, 244-251. [Google Scholar] [CrossRef] [PubMed]
[36] Heliopoulos, J., Vadikolias, K., Piperidou, C. and Mitsias, P. (2011) Detection of Carotid Artery Plaque Ulceration Using 3-Dimensional Ultrasound. Journal of Neuroimaging, 21, 126-131. [Google Scholar] [CrossRef] [PubMed]
[37] Saba, L., Yuan, C., Hatsukami, T.S., Balu, N., Qiao, Y., DeMarco, J.K., et al. (2018) Carotid Artery Wall Imaging: Perspective and Guidelines from the ASNR Vessel Wall Imaging Study Group and Expert Consensus Recommendations of the American Society of Neuroradiology. American Journal of Neuroradiology, 39, E9-E31. [Google Scholar] [CrossRef] [PubMed]
[38] Rafailidis, V., Chryssogonidis, I., Xerras, C., Nikolaou, I., Tegos, T., Kouskouras, K., et al. (2018) A Comparative Study of Color Doppler Imaging and Contrast-Enhanced Ultrasound for the Detection of Ulceration in Patients with Carotid Atherosclerotic Disease. European Radiology, 29, 2137-2145. [Google Scholar] [CrossRef] [PubMed]
[39] Lyu, Q., Tian, X., Ding, Y., Yan, Y., Huang, Y., Zhou, P., et al. (2020) Evaluation of Carotid Plaque Rupture and Neovascularization by Contrast-Enhanced Ultrasound Imaging: An Exploratory Study Based on Histopathology. Translational Stroke Research, 12, 49-56. [Google Scholar] [CrossRef] [PubMed]
[40] Kopyto, E., Czeczelewski, M., Mikos, E., Stępniak, K., Kopyto, M., Matuszek, M., et al. (2023) Contrast-Enhanced Ultrasound Feasibility in Assessing Carotid Plaque Vulnerability—Narrative Review. Journal of Clinical Medicine, 12, Article 6416. [Google Scholar] [CrossRef] [PubMed]
[41] Zhang, L., Wu, R., Chen, J., Gu, S. and Jia, C. (2025) The Role of Intraplaque Neovascularization in Recent and Future Ischemic Stroke in Patients with Mild Carotid Stenosis. Ultrasonography, 44, 62-71. [Google Scholar] [CrossRef] [PubMed]
[42] Yang, F. and Wang, C. (2020) Consistency of Superb Microvascular Imaging and Contrast-Enhanced Ultrasonography in Detection of Intraplaque Neovascularization: A Meta-Analysis. PLOS ONE, 15, e0230937. [Google Scholar] [CrossRef] [PubMed]
[43] Noflatscher, M., Schreinlechner, M., Sommer, P., Kerschbaum, J., Berggren, K., Theurl, M., et al. (2018) Influence of Traditional Cardiovascular Risk Factors on Carotid and Femoral Atherosclerotic Plaque Volume as Measured by Three-Dimensional Ultrasound. Journal of Clinical Medicine, 8, Article 32. [Google Scholar] [CrossRef] [PubMed]
[44] Jinnouchi, H., Sato, Y., Sakamoto, A., Cornelissen, A., Mori, M., Kawakami, R., et al. (2020) Calcium Deposition within Coronary Atherosclerotic Lesion: Implications for Plaque Stability. Atherosclerosis, 306, 85-95. [Google Scholar] [CrossRef] [PubMed]
[45] Ruan, W., He, Y., Shao, X., Yang, S., Li, X., Ding, J., et al. (2021) The Ability of Micropure® Ultrasound Technique to Identify Microcalcifications in Carotid Plaques. Clinical Neurology and Neurosurgery, 201, Article ID: 106401. [Google Scholar] [CrossRef] [PubMed]
[46] Zhang, L., Lyu, Q., Ding, Y., Hu, C. and Hui, P. (2022) Texture Analysis Based on Vascular Ultrasound to Identify the Vulnerable Carotid Plaques. Frontiers in Neuroscience, 16, Article 885209. [Google Scholar] [CrossRef] [PubMed]
[47] Zhang, R., Zhang, Q., Ji, A., Lv, P., Zhang, J., Fu, C., et al. (2020) Identification of High-Risk Carotid Plaque with MRI-Based Radiomics and Machine Learning. European Radiology, 31, 3116-3126. [Google Scholar] [CrossRef] [PubMed]
[48] Wang, X., Luo, P., Du, H., Li, S., Wang, Y., Guo, X., et al. (2022) Ultrasound Radiomics Nomogram Integrating Three-Dimensional Features Based on Carotid Plaques to Evaluate Coronary Artery Disease. Diagnostics, 12, Article 256. [Google Scholar] [CrossRef] [PubMed]