颈动脉斑块MR高清成像与颈动脉超声的对比研究

发布时间：2018-03-10 03:36

本文选题：颈动脉斑块　切入点：粥样硬化　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究将传统超声测量颈动脉斑块最厚处管壁厚度、管腔面积、管壁面积、血管总面积并计算管壁标准化指数五项指标,与MR颈动脉斑块成像五项指标进行对比研究,以此评价MRI与超声检测斑块负荷的一致性。方法:选择经超声和高清MRI检出并匹配的45个颈动脉斑块病例21例,男15例,女6例,平均年龄61.3±9.9岁。其中吸烟7例,饮酒11例,高脂血症10例,高血压10例,糖尿病8例,合并脑梗死5例。由两名有经验医师评价图像的质量,观察斑块的个数及分布(本研究不包含颈外动脉斑块),并分别测量颈动脉斑块最厚处的最大管壁厚度(Maximal wall thickness,MWT)、管腔面积(Lumen area,LA)、管壁面积(Wall area,WA)、血管总面积(Total vascular area,TVA)、用管壁面积除以血管总面积计算得出管壁标准化指数(Normalized wall index,NWI),对五项形态学指标进行一致性分析。结果:45个斑块的位置分别是:左颈总动脉7个,右颈总动脉7个,左侧分叉处9个,右侧分叉处10个,左侧颈内动脉5个,右侧颈内动脉7个。斑块引起的管腔狭窄程度,两种检查结果一致性达93.3%(42/45)。颈动脉斑块高清MRI所测得的平扫斑块厚度2.88 mm、平均管腔面积45.94mm2、平均管壁面积40.5 mm2、平均血管总面积86.66 mm2和平均NWI值0.50。颈动脉超声所测得的平均斑块厚度2.56mm、平均管腔面积43.05 mm2、平均管壁面积40.16 mm2、平均血管总面积82.59 mm2和平均NWI值0.50。经统计学处理,颈动脉斑块高分辨率磁共振与颈动脉超声所测得的斑块厚度、管腔面积、管壁面积、血管总面积和NWI值均无明显统计学差异(P0.05)。结论:颈动脉高清MR与传统超声在测量斑块负荷方面存在良好的一致性,两种检查方法均可以对斑块负荷进行精确评价。
[Abstract]:Objective: To study the traditional ultrasound measurement of carotid plaque thickest wall thickness, lumen area, wall area, total vessel area and calculate the five indexes of normalized wall index, compared with the five indexes of MR of carotid artery plaque imaging, to evaluate the consistency of MRI and ultrasonic detection of plaque load. Methods: 21 cases of 45 cases of carotid artery plaque by ultrasound and HD MRI detection and matching, male 15 cases, female 6 cases, mean age 61.3 + 9.9 years. Among them, 7 cases of smoking and drinking in 11 cases, 10 cases of hyperlipidemia, 10 cases of hypertension, 8 cases of diabetes, 5 cases complicated with cerebral infarction. By two experienced physicians to evaluate the quality of the image, observe the plaque number and distribution (this study does not include the external carotid artery plaque), the maximum wall thickness were measured and the thickness of carotid plaque (Maximal wall, thickness, MWT), lumen area (Lumen area, LA), wall area (Wall area, WA The total vessel area (Total), vascular area, TVA), with the wall area divided by the total vessel area calculated normalized wall index (Normalized wall, index, NWI), consistency analysis of five morphological indexes. Results: the 45 patch position are: the left carotid artery in 7, right the common carotid artery in 7, left at 9, 10 on the right side of the left internal carotid artery bifurcation, 5, 7. Right internal carotid artery stenosis caused by plaque, two examination results consistency reached 93.3% (42/45). Carotid plaque HD MRI measured plain plaque thickness 2.88 mm, average the lumen area is 45.94mm2, average wall area of 40.5 mm2, the average total vessel area of 86.66 mm2 and the average NWI value of the average plaque thickness measured by 2.56mm 0.50., carotid artery ultrasound, the average cross-sectional area of 43.05 mm2, the average wall area of 40.16 mm2, the average total vessel area of 82.59 mm2 and the average NWI value of 0.5 0. after statistical treatment, carotid artery plaque high resolution magnetic resonance imaging and carotid ultrasound measurement of plaque thickness, lumen area, wall area, there were no statistically significant differences in the total vessel area and the value of NWI (P0.05). Conclusion: carotid artery HD MR and traditional ultrasound are in good agreement in the measurement of plaque burden two, examination methods can be accurate assessment of plaque burden.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R543.4;R445

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