应用剪切波弹性成像评价急性缺血性脑卒中患者颈动脉弹性及其相关因素  

Evaluation of carotid artery elasticity and its related factors in patients with acute ischemic stroke using shear wave elastography

作　　者：李朝军[1] 金琳 王枫[3] 伍瑛[1] 刘阳[1] 高峰[1] 杜联芳[1] 

机构地区：[1]上海交通大学附属第一人民医院超声科,200080 [2]上海市嘉定区中心医院超声科 [3]上海交通大学附属第一人民医院神经内科,200080

出　　处：《中华超声影像学杂志》2015年第7期571-575,共5页Chinese Journal of Ultrasonography

基　　金：上海市卫生和计划生育委员会基金（201440291））;上海市科学技术委员会医学引导类科技项目（15411969100）

摘　　要：目的应用剪切波弹性成像检测急性缺血性脑卒中患者颈动脉纵向弹性模量，初步探讨其可行性及相关因素。方法急性缺血性脑卒中患者179例，根据TOAST分型，大动脉粥样硬化性脑梗死103例，腔隙性脑梗死76例。年龄、性别匹配的对照组168例。超声射频技术测量双侧颈动脉脉搏波传导速度（PWV）；实时剪切波弹性成像（SWE）检测双侧颈动脉浅壁20个感兴趣区纵向平均弹性模量的平均值（MEmean）、最大弹性模量的平均值（MEmax）和最小弹性模量的平均值（MEmin）。采用多元线性回归分析MEmean独立影响因素。结果①与对照组相比，脑卒中患者颈动脉僵硬度参数PWV增大（P〈0．05）；②脑卒中患者颈动脉浅壁纵向弹性模量参数MEmean和MEmax均大于对照组（P〈0．05）；③年龄、收缩压、PWV和低密度脂蛋白胆固醇（LDL—C）与MEmean呈正相关（r分别为O．221、0．174、0．776和0．173，P〈0．05），是MEmean的独立影响因素。结论SWE可检测颈动脉纵向弹性模量评价动脉僵硬度；年龄、收缩压、PWV和LDL是颈动脉纵向弹性模量的独立影响因素。Objective To measure the longitudinal elastic modulus in patients with acute ischemic stroke by shear wave elasotography（SWE） ,and to study its feasibility and related factors. Methods There were 179 cases with acute ischemic stroke （AIS） including 103 cases with large artery atherosclerosis and 76 cases with lacunar infarction classified according to the TOAST classification. There were 168 age and sex- matched cases as control group. Pulse wave velocity （PWV） of bilateral carotid was measured by radiofrequency ultrasound. The 20 areas of superficial walls of bilateral carotid artery were analyzed by SWE, and the average values of longitudinal average elastic modulus （ME ）, the maximum elastic modulus （MEmax） and minimum elastic modulus （MEmin） were calculated. The independent factors of ME were analyzed using multiple linear regression analysis. Results （1）Compared with control group, PWV in patients with AIS was increased （ P 〈0.05）. （2）The MEmax and ME of carotid artery in patients with AIS were more than those in the control group （ P 〈0.05）. （3）Age,systolic blood pressure,PWV and low-density lipoprotein cholesterol（LDL-C） were positively related to ME （r = 0.221,0.174,0.776 and 0.173,respectively, P 〈0.05）,and were independent factors for ME Conclusions SWE can evaluated the arterial stiffness using longitudinal elastic modulus of carotid. Age, systolic blood pressure, PWV and LDL were independent factors for longitudinal elastic modulus.

关 键 词：弹性成像技术 卒中 颈动脉 僵硬度 脉搏波传播速度 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]