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  

Assessment of the rabbit carotid atherosclerotic plaques using ultrasound real-time tissue elastography technique with pathologic correlation

作　　者：李玲[1] 朱建平[1] 蒋彦彦[1] 江丽[1] 洪峻峰[1] 

机构地区：[1]福州总医院超声诊断科,350025

出　　处：《中华医学超声杂志（电子版）》2016年第3期231-236,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：福建省自然科学基金资助项目(2012J01409)

摘　　要：目的探讨超声实时组织弹性成像（RTE）技术在颈动脉易损斑块检测中的应用价值。方法健康雄性大耳白兔15只,体重2~2.5 kg,高脂喂养联合空气干燥术建立兔颈动脉粥样硬化模型（CAS）,常规超声将颈动脉斑块回声分为4种类型,RTE技术获得各型斑块的弹性硬度指数和硬度比值Ratio值,并分析斑块常规超声分型与弹性参数、病理分型之间的相关性。结果 15只实验兔成功建立28条CAS模型,51个斑块中34个纳入实验。斑块4组超声分型与病理类型呈正相关（r=0.602,P〈0.01）。弹性硬度指数、硬度比值Ratio值与常规超声斑块分型亦呈正相关（r=0.538,0.563,P值均〈0.01）。弹性硬度指数中,Ⅰ型与Ⅱ型、Ⅱ型与Ⅲ型差异无统计学意义,Ⅰ型与Ⅲ型、Ⅰ型与Ⅳ型、Ⅱ型与Ⅳ型、Ⅲ型与Ⅳ型比较,差异具有统计学意义（t=2.25,2.08,2.95,2.57,P值均〈0.05）。硬度比值Ratio值中,Ⅰ型与Ⅱ型差异无统计学意义,Ⅰ型与Ⅲ型、Ⅰ型与Ⅳ型、Ⅱ型与Ⅲ型、Ⅱ型与Ⅳ型、Ⅲ型与Ⅳ型比较,差异均有统计学意义（t=2.66,2.91,2.45,2.60,2.12,P值均〈0.05）。结论 RTE技术能够应用弹性参数量化斑块性质,间接反映斑块病理结构,可能为易损斑块的评估提供有用的指标。Objective To investigate the application value of ultrasound real-time tissue elastography technology（RTE） in the detection of the vulnerable carotid atherosclerotic plaques. Methods The carotid atherosclerosis models（CAS） of rabbits were established by high fat feeding combined with air drying technique treatment in 15 healthy male large-ear rabbits weighting 2-2.5 kg. The plaques were classified into 4 types based on the conventional ultrasound analysis and the elastic hardness index. The hardness ratio of plaque in each type was further analyzed by using RTE technique. Then the correlations between the conventional ultrasound classification and elastic parameter and histological type were analyzed. Results 28 CAS models were successfully established from the 15 rabbits, among them 34 of the 51 plaques were included in this investigation. A positive correlation（r=0.602, P〈0.01） of plaques classified by ultrasound and their pathological types was observed in all the four groups. The positive correlations（r=0.538, 0.563, both P〈0.01） between the conventional ultrasound classification and the elastic hardness index and the hardness ratio were also detected. In terms of plaque elastic hardness index, no significant differences between Group Ⅰ and Ⅱ and group Ⅱ and Ⅲ were detected. However, there were significant differences in other comparisons： Ⅰ vs Ⅲ, Ⅰ vs Ⅳ, Ⅱ vs Ⅳ and Ⅲ vs Ⅳ group（t=2.25, 2.08, 2.95, 2.57, all P〈0.05）. In comparison of the hardness ratio, no difference was detected between group Ⅰ and group Ⅱ. However, there were significant differences among the other groups： Ⅰ vs Ⅲ, I vs Ⅳ, Ⅱ vs Ⅲ, Ⅱ vs Ⅳ and Ⅲ vs Ⅳ group（t=2.66, 2.91, 2.45, 2.60, 2.12, all P〈0.05）. Conclusion RTE technology can be used to quantify plaque characteristics by using the elastic parameters, which may indirectly reflect the pathological structures of plaques, probably providing a useful index for assessment of vulnerable plaque.

关 键 词：颈动脉 硬化 超声检查 弹性成像技术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.4[医药卫生—诊断学]