弹性成像技术在颈动脉斑块诊断中的应用价值

发布时间：2018-04-03 12:01

本文选题：超声检查　切入点：颈动脉粥样硬化斑块　出处：《宁夏医科大学》2014年硕士论文

【摘要】：目的探讨弹性成像技术面积比值法在颈动脉斑块诊断中的应用价值，并应用实时超声弹性成像量化值（面积比）评价脑梗死患者颈动脉斑块，探讨弹性成像技术评价颈动脉斑块稳定性的价值。方法对75例门诊患者颈动脉行常规超声检查，检测其斑块部位、数量、大小及回声强度，切换至弹性成像模式进行实时观察斑块，图像显示清晰且QF达到60及以上时冻结图像，分别勾画斑块在二维图和弹性图的区域，勾画三次，取平均值，仪器分别自动测出所勾画的面积，并计算弹性比值（面积比=弹性图面积/二维图面积，即A2/A1）。在上述研究结果分析基础上，采用常规超声检查45例脑梗死患者颈动脉，首先确定有无斑块及斑块部位、大小及回声强度，超声确定斑块后，切换至弹性成像模式进行实时观察斑块，用同样方法计算斑块弹性比值（面积比=弹性图面积/二维图面积，即A2/A1）。结果在75例门诊患者中，二维超声检出颈动脉斑块共计52处，76.92%位于颈总动脉分叉处（40/52），其中低回声斑块35处，高回声斑块11处，不均质回声斑块8处；弹性成像检出46处斑块，检出率为88.4%（46/52）；低回声斑块、不均质回声斑块、高回声斑块二维与弹性成像面积比值依次增大,差异有高度统计学意义（P=0.001, P0.05），余两两之间有统计学意义（P0.05）。分析45例脑梗死患者结果，其中12例无斑块，余33例常规超声检测到35处颈动脉粥样硬化斑块，其中低回声斑块4处、等回声斑块5处、高回声斑块11处，不均质回声斑块15处；低回声斑块、不均质回声斑块、等回声斑块、高回声斑块弹性比值依次增大,差异有统计学意义（P=0.001, P0.05）；低回声和不均质回声之间无统计学意义（P=0.15, P0.05），等回声和不均质回声之间无统计学意义（P=0.763，P0.05），余两两之间有差异，，有统计学意义（P0.05）。结论超声弹性成像技术可用于评价颈动脉斑块硬度，不同组织声学特性的斑块面积比值不同，可以作为斑块稳定性判断的较好指标，对临床缺血性脑病的预防和诊治有重要意义。
[Abstract]:Objective to evaluate the value of area ratio of elastic imaging technique in the diagnosis of carotid plaques, and to evaluate carotid plaques in patients with cerebral infarction by using the quantitative value (area ratio) of real-time elastography.To evaluate the value of elastic imaging in evaluating the stability of carotid plaques.Methods the carotid artery of 75 outpatients was examined by conventional ultrasound. The location, number, size and echo intensity of the plaque were detected. The plaque was observed in real time by using elastic imaging mode. The frozen image showed clearly and the QF reached 60 or above.The plaques are drawn in the region of two dimensional and two dimensional maps respectively, drawing three times, taking the average value, measuring the area drawn by the instrument automatically, and calculating the elastic ratio (area ratio = the area of the elastic diagram / the area of the two-dimensional map, that is, A _ 2 / A _ 1 ~ (1)).On the basis of the analysis of the above results, 45 patients with cerebral infarction were examined by conventional ultrasound. The plaque and its location, size and echo intensity were first determined, and the plaque was determined by ultrasound.The patch was observed in real time by switching to elastic imaging mode, and the elastic ratio of patch (area ratio = elastic map area / two-dimensional map area) was calculated by the same method.Results in 75 outpatients, 52 carotid plaques were detected by two-dimensional ultrasound, 76.92% of them were located at the bifurcation of common carotid artery, 35 hypoechoic plaques, 11 hyperechoic plaques, 8 heterogeneous plaques, 46 plaques were detected by elastic imaging.The detectable rate was 88.4 / 52, and the ratio of hypoechoic plaques, non-echoic plaques and hyperechoic plaques to elastic imaging area increased in turn, the difference was statistically significant (P < 0.001), P 0.05 (P 0.05), and P 0.05 (P 0.05).The results of 45 patients with cerebral infarction were analyzed, including 12 cases without plaque, and 33 cases with 35 carotid atherosclerotic plaques, including 4 hypoechoic plaques, 5 isoechoic plaques, 11 hyperechoic plaques.The elastic ratio of hypoechoic plaques, hypoechoic plaques, isoechoic plaques and hyperechoic plaques increased in turn.Conclusion Ultrasound elastic imaging can be used to evaluate the carotid plaque hardness, and the plaque area ratio of different tissue acoustic characteristics is different, which can be used as a better index to judge the plaque stability.It is of great significance for the prevention, diagnosis and treatment of ischemic encephalopathy.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R743.3

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