颈总动脉内中膜增厚患者低壁面剪应力分布的探讨  

Study on distributions of low wall shear stress in common carotid arteries of patients with intima-media thickening

作　　者：黄志芳[1] 陈明[1] 王超[1] 张宇辉[1] 刘秋云[2] 

机构地区：[1]同济大学附属东方医院心脏中心,上海200120 [2]上海市浦东新区公利医院超声科

出　　处：《中华超声影像学杂志》2013年第3期208-212,共5页Chinese Journal of Ultrasonography

基　　金：浦东新区科技发展基金创新资金（PKJ2010Y16）;上海市浦东新区心血管疾病学科群项目（PWZxkq2010-01）

摘　　要：目的采用血流剪应力可视化定量分析软件，分别测定健康人和内中膜增厚患者的颈总动脉壁面剪应力（wallshearstress，WSS），分析WSS的空间分布规律。方法提取50例健康人（健康组）和50例内中膜增厚患者（增厚组）颈总动脉彩色多普勒血流图像DICOM文件，运用血流剪应力可视化定量分析软件绘制颈总动脉WSS二维空间分布图、三维空间分布图和WSS数据，进行图像和数据分析。结果健康组WSS的变化范围在4～14dyn／cm2 之间（1dyn=10-5N），增厚组WSS的变化范围在2～6dyn／cm。之间。增厚组WSS平均值[（2．87±0．59）dyn／cm2]显著低于健康组[（6．91±1．20）dyn／cm2]，差异具有统计学意义（t=17．828，P=0．000）。结论内中膜增厚患者颈总动脉局部产生了低WSS区，说明局部血流动力学的改变引起的WSS降低与颈总动脉内中膜增厚有关。Objective To measure wall shear stress （WSS） in common carotid arteries of normal subjects and patients with intima-media thickening and analyze the spatial distribution of low wall shear stress by quantitative analysis of blood flow shear stress visualization software. Methods Color Doppler flow images of common carotid arteries in normal subjects （control group） and patients with intima-media thickening （study group） were extracted from DICOM files. Two-dimensional distribution images of WSS, three-dimensional distribution images of WSS and the value of WSS in the common carotid arteries were obtained by this new algorithm. Then, the data and images of WSS were analyzed. Results WSS in the common carotid arteries of the control group were ranged from 4 to14 dyn/cm2. WSS in the common carotid arteries of the study group were ranged from 2 to 6 dyn/cm2. Conlpared to mean WSS values [（6.91± 1.20） dyn/cm2] in common carotid arteries of the control group, mean WSS values [（2.87± 0.59） dyn/cm2]in common carotid arteries of the study group was significantly lower （ t = 17. 828, P = 0. 000）. Conclusions Low WSS areas have been emerged in local common carotid arteries in the patients with intima-media thickening. The reduction of WSS caused by local hemodynamic change might be related to common carotid artery intima-media thickening.

关 键 词：超声检查 颈总动脉 动脉粥样硬化 壁面剪应力 

分 类 号：R445.1[医药卫生—影像医学与核医学]