应用速度向量成像技术评价T2DM患者颈动脉斑块长轴力学特征

发布时间：2018-04-21 00:34

本文选题：速度向量成像技术 + 动脉粥样硬化　；参考：《南京医科大学》2014年硕士论文

【摘要】：研究目的 1)应用VVI技术研究糖尿病组和正常对照组颈动脉斑块长轴力学特征； 2)比较两组之间各个感兴趣区力学指标的差异; 3)比较两组内各个感兴趣区力学指标的差异,指出哪些指标可用于提示斑块的受力情况。研究方法选取2型糖尿病患者合并颈动脉斑块50例,颈动脉斑块不伴2型糖尿病患者50例作为对照组,应用速度向量成像技术比较两组间及两组内各点速度、应变力和应变率三个指标间的差异。采用SPSS16.0统计软件进行分析,计量资料以均数加减标准差表示,结果均以P0.05为有显著性意义。两组间斑块同一位置ROI同一参数比较应用两样本独立t检验,两组内斑块不同ROI各参数比较应用单因素方差分析,本组符合Levene方差齐性检验并采用LSD检验方法进行多重比较。研究结果一、两组一般情况比较糖尿病组的年龄、性别、TC、TG、HDL、LDL与对照组比较无统计学意义(P0.05),糖尿病组空腹血糖较对照组明显增高,差异有统计学意义(P0.05)。二、两组间斑块VVI各指标间的比较糖尿病组的速度、应变力及应变率等各项指标均较对照组减小(见表1)；三、两组内斑块不同ROI间各VVI指标间的比较 3.1速度 3.1.1糖尿病组内斑块速度均是先从R1到R4减小,再从R4到R5增大；其中R1点速度正向峰值、负向峰值及峰值差值与R3、R4、R5相对应指标比较有统计学意义(P0.05)； 3.1.2对照组速度正向峰值、负向峰值、峰值差值变化趋势是先减小再增大,且各ROI间速度比较没有统计学意义(P0.05)； 3.2应变力 3.2.1糖尿病组内斑块应变力正向峰值、负向峰值、峰值差值从R1到R2增大,R2到R4减小,再从R4到R5增大,其中R2点应变力正向峰值与R1、R3、R4、R5相对应指标比较有统计学意义(P0.01,表2)； 3.2.2对照组应变力正向峰值、负向峰值、峰值差值没有明显有规律的变化趋势； 3.3应变率 3.3.1糖尿病组内斑块应变率各指标变化趋势与应变表现相似,其中R2点应变率正向峰值与R4点比较有统计学意义(P0.05,表3)； 3.3.2对照组内斑块应变率正向峰值、负向峰值、峰值差值无明显有规律的变话趋势。研究结论 1、通过VVI技术发现糖尿病组颈动脉斑块各指标较正常对照组减低,表明糖尿病组颈动脉斑块整体机械性能下降； 2、通过组内各指标的分析比较得出颈动脉斑块近心端肩部较其他各点受力更大,即更易破裂； 3、VVI技术可以在一定程度上评价T2DM患者颈动脉斑块长轴上力学特征。
[Abstract]:Research purpose 1) VVI technique was used to study the long axis mechanical characteristics of carotid plaque in diabetic group and normal control group. 2) to compare the difference of mechanical indexes between the two groups in each region of interest; 3) to compare the differences of mechanical indexes between the two groups in different regions of interest, and to point out which indexes can be used to indicate the number of plaques. Stress. Research method Fifty patients with type 2 diabetes mellitus complicated with carotid artery plaque and 50 patients with carotid plaque without type 2 diabetes mellitus were selected as control group. Velocity vector imaging was used to compare the velocities of each point between two groups and within two groups. The difference between the three indexes of strain and strain rate. The statistical software of SPSS16.0 was used to analyze, and the measurement data were expressed as the standard deviation of mean addition and subtraction, and the results were all significant in the form of P0.05. Single factor analysis of variance (ANOVA) was used to compare the same ROI parameters of plaque at the same location between the two groups and the plaque ROI parameters in the two groups. The homogeneity test of Levene variance and the LSD test method were used to carry out multiple comparisons between the two groups. Research results One, two groups of general comparison There was no significant difference in age, sex, age and sex between the two groups (P 0.05). The fasting blood glucose in the diabetic group was significantly higher than that in the control group (P 0.05). Comparison of plaque VVI between the two groups; the velocity, strain and strain rate of diabetic group were lower than those of the control group (see Table 1). Comparison of different VVI Indexes between plaque and different ROI in two groups 3.1 Speed 3.1.1 plaque velocities in diabetic group were decreased from R1 to R4, then increased from R4 to R5, where the positive peak, negative peak value and difference between R1 and R4 R5 were significantly higher than those in R3 / R4 / R5 group (P < 0. 05). 3.1.2 in the control group, the change trend of the positive and negative peak velocity and the difference value of the peak value was to decrease first and then to increase, and there was no significant difference between the ROI and each other (P 0.05). 3.2 strain 3.2.1 the positive peak and negative peak of plaque strain in diabetes mellitus group, the difference of peak value increased from R1 to R2 to decrease from R2 to R4, and then increased from R4 to R5, in which the positive peak value of R2 point was significantly higher than that of R1 / R3 / R4 / R5 (P < 0.01). 3.2.2 in the control group, the positive peak value, negative peak value and the difference value of the peak value did not have a regular change trend. 3.3 strain rate 3.3.1 the variation trend of plaque strain rate in diabetic group was similar to that of strain, and the positive peak value of R2 point strain rate was significantly higher than that of R4 point (P 0.05). 3.3.2 in the control group, the positive peak value, negative peak value and difference value of plaque strain rate had no obvious tendency to change words regularly. Research conclusion 1. The results of VVI showed that the indexes of carotid plaques in diabetic group were lower than those in normal control group, which indicated that the mechanical properties of carotid plaques in diabetic group were lower than those in normal control group. 2, through the analysis and comparison of the indexes in the group, it was concluded that the proximal shoulder of carotid plaque was more forced than other points, that is, it was easier to rupture; VVI technique can be used to evaluate the long axis mechanical characteristics of carotid plaques in patients with T2DM.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2

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