超声实时组织弹性技术评估兔颈动脉粥样硬化斑块分型与病理的对照研究

发布时间：2018-09-09 11:39

【摘要】：【目的】通过建立兔颈动脉粥样硬化（CAS）斑块模型，观察斑块不同灰阶超声分型与病理类型、弹性系数（弹性硬度指数、硬度对比Ratio值）之间的相关性，获得不同灰阶超声斑块分型的弹性系数，总结实时组织弹性成像技术（RTE）在斑块检测中的应用体会，为该技术在颈动脉斑块分型中的应用提供实验病理依据。【材料与方法】本研究分为两部分：1、应用高脂饮食联合空气干燥术建立实验兔CAS模型。2、利用GE LOGIQE9超声诊断仪获得斑块的二维灰阶分型、弹性硬度指数、硬度对比值Ratio值，所有的病例均经病理证实。采用秩相关分析斑块灰阶超声分型与病理分类、弹性系数相关性，不同灰阶超声分型斑块多组均数比较采用单因素方差分析，组间两两比较使用LSD。【结果】 15只实验兔共30条颈动脉，2条颈动脉出现闭塞性改变，，成功建立了28条CAS模型，共51例斑块，纳入实验的CAS斑块数为34例。斑块灰阶超声分型和病理类型、弹性系数之间呈正相关。不同灰阶分型斑块弹性硬度指数、弹性对比Ratio不全相同。不同灰阶分型斑块的弹性硬度指数中,除了I组与II组、II组与III组之间差别无统计学意义，其余两两组比较差别有统计学意义。不同灰阶分型斑块的硬度对比Ratio值中，除了I组与II组之间差别无统计学意义，余两两间有差别有统计学意义。【结论】 1、高脂饮食联合空气干燥术可建立兔颈动脉CAS模型，造模时间短、方法简便，成功率高。 2、斑块灰阶超声分型与病理类型、弹性系数之间呈正相关。 3、不同灰阶超声分型斑块的弹性系数不同，灰阶超声分型越高，弹性硬度指数、硬度对比Ratio值越高。 4、实时组织弹性成像在评估兔颈动脉斑块分型的应用可行性较高，但因影响因素多，对操作者手法技能要求高，可重复性受到限制，目前仍属于实验研究阶段。本实验例数较少，所得结果仅供参考。
[Abstract]:[objective] to observe the correlation between ultrasonic classification and pathological type, elastic coefficient (elastic hardness index, hardness versus Ratio value) of carotid atherosclerotic (CAS) plaque in rabbits. The elastic coefficients of different gray-scale ultrasound plaques were obtained, and the application of real-time tissue elastic imaging (RTE) in plaque detection was summarized. [materials and methods] this study was divided into two parts: 1, using high-fat diet combined with air drying to establish CAS of experimental rabbits. Model .2. the two-dimensional gray scale classification of plaque was obtained by GE LOGIQE9 ultrasonic diagnostic instrument. The elastic hardness index and hardness contrast value (Ratio) were confirmed by pathology in all cases. Rank correlation analysis was used to analyze the correlation between plaque gray-scale ultrasonic classification and pathological classification, and the correlation between elastic coefficient and multigroup mean number of plaques in different gray-scale ultrasonic classification was analyzed by univariate analysis of variance (ANOVA). [results] A total of 30 carotid arteries and 2 carotid arteries were occluded in 15 experimental rabbits. A total of 28 CAS models were successfully established in 51 cases of plaques, and 34 cases of CAS plaques were included in the experiment. There was a positive correlation between ultrasonic classification and pathological type and elastic coefficient of plaques. The elastic hardness index of plaques of different gray-scale types, elastic contrast Ratio are not all the same. In the elastic hardness index of plaques of different gray-scale types, there was no significant difference between group I and group II, group II and group III, but there were significant differences between the other two groups. There was no significant difference in the hardness of plaques between groups I and II except for the Ratio values of different gray-scale plaques. [conclusion] 1. The CAS model of rabbit carotid artery can be established by high fat diet combined with air drying. The success rate was high. 2. There was a positive correlation between the ultrasonic classification of plaques and pathological type and elastic coefficient. 3. The elastic coefficient of plaques was different in different gray scale ultrasonic typing. The higher the classification of gray scale ultrasound was, the higher the elastic hardness index was. The higher the Ratio value of hardness contrast, the higher the feasibility of real-time tissue elastic imaging in evaluating carotid plaque classification in rabbits. However, due to many influencing factors, the operator's manual skills were required and the repeatability was limited. At present, it still belongs to the stage of experimental research. There are few examples in this experiment, and the results are for reference only.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1

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