Comparison of ultrasound and CT angiography examination in the diagnosis of carotid plaque

ZHANG Ke; TANG Zhong-cai; CHEN Ying; YI Zhao-xiong; BAI Yan-hong; LI Ya-fen

doi:10.11659/jjssx.11E025031

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Comparison of ultrasound and CT angiography examination in the diagnosis of carotid plaque

Clinical Research | 更新时间：2026-06-16

- Comparison of ultrasound and CT angiography examination in the diagnosis of carotid plaque
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 6, Pages: 547-550(2026)
- 作者机构：
  
  1.西安交通大学医学部附属三二〇一医院超声医学科，陕西汉中 723000
  2.西安交通大学医学部，陕西西安 710000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.11E025031
  CLC： R543.4;R445.1
- Received：06 November 2025，
  
  Published：25 June 2026
- 稿件说明：
移动端阅览
张科,唐中才,陈颖等.超声与CT血管成像检查对颈动脉斑块的诊断比较[J].局解手术学杂志,2026,35(06):547-550.

ZHANG Ke,TANG Zhong-cai,CHEN Ying,et al.Comparison of ultrasound and CT angiography examination in the diagnosis of carotid plaque[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(06):547-550.
张科,唐中才,陈颖等.超声与CT血管成像检查对颈动脉斑块的诊断比较[J].局解手术学杂志,2026,35(06):547-550. DOI： 10.11659/jjssx.11E025031.

ZHANG Ke,TANG Zhong-cai,CHEN Ying,et al.Comparison of ultrasound and CT angiography examination in the diagnosis of carotid plaque[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(06):547-550. DOI： 10.11659/jjssx.11E025031.

摘要

目的

比较超声与CT血管成像（CTA）在无症状人群颈动脉斑块中的检出效能。

方法

纳入2022年3月至2023年3月我院86例无症状体检者，同期行颈动脉超声与颈动脉-冠状动脉联合CTA检查。由2名经验丰富的医师独立完成超声图像分析并评估观察者内及观察者间的一致性，超声检测颈动脉斑块及内中膜厚度（IMT）；CTA量化分析颈动脉与冠状动脉斑块的位置、体积及成分。

结果

超声对颈动脉斑块检出及总斑块体积评估的观察者内、观察者间一致性均为良好（

Kappa

值0.63~0.79）。以CTA为金标准，超声对颈动脉斑块的检出率为18.60%，显著低于CTA的32.56%（

²=4.72，

=0.030）。超声检出组钙化斑块占比显著高于超声未检出组，低密度非钙化斑块占比显著低于超声未检出组，差异均有统计学意义（

0.05）。超声检测的颈动脉IMT与CTA检测的颈动脉斑块总体积呈正相关（

=0.58，

0.001）

。超声检出组与超声未检出组冠状动脉斑块检出率无显著差异（

0.05）。

结论

超声对无症状人群颈动脉斑块存在明显低估，尤其易漏诊分叉处的低密度非钙化易损斑块。临床应采用分层诊断策略，结合两种检查方法以提高诊断准确性及心血管风险评估的可靠性。

Abstract

Objective

To compare the detection efficacies of ultrasound and CT angiography （CTA） for carotid plaques in asymptomatic populations.

Methods

A total of 86 asymptomatic individuals undergoing physical examination from March 2022 to March 2023 in our hospital were enrolled and underwent concurrent carotid ultrasound and combined carotid-coronary CTA. Ultrasound image analysis was independently performed by two experienced physicians， and intra-observer and inter-observer consistency were evaluated. Ultrasound was used to evaluate carotid plaques and intima-media thickness （IMT）.CTA was used to quantitatively analyze the location，volume，and composition of carotid and coronary plaques.

Results

The intra-observer and inter-observer consistency of ultrasound for carotid plaque detection and total plaque volume assessment were both good （

Kappa

value ranged from 0.63 to 0.79）. Taking CTA as the gold standard，the detection rate of carotid plaques by ultrasound was 18.60%，which was significantly lower than that of 32.56% by CTA （

²=4.72，

=0.030）.The proportion of calcified plaques in the ultrasound-detected group was significantly higher than that in the ultrasound‑undetected group，whereas the proportion of low-density non-calcified plaques was significantly lower than that in the ultrasound-undetected group，with statistically significant differences （

0.05）. The carotid IMT measured by ultrasound was positively correlated with total carotid plaque volume detected by CTA （

=0.58，

0.001）. There was no significant difference in the detection rate of coronary plaques between the ultrasound

-detected group and ultrasound-undetected group（

0.05）.

Conclusion

Ultrasound significantly underestimates carotid plaques in asymptomatic individuals， and is particularly prone to missing low-density non-calcified vulnerable plaques at the bifurcation. Clinically， A stratified diagnostic strategy should be adopted， and combining both ultrasound and CTA examination methods can improve diagnostic accuracy and the reliability of cardiovascular risk assessment.

关键词

Keywords

references

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