基于对比增强流场的2型糖尿病患者颈动脉窦区壁剪应力分布分析  

Wall shear stress distribution in carotid sinus of type 2diabetes mellitus patients based on contrast enhanced flow field

作　　者：梁婷[1] 董云[1] 崔峥[1] 高一[1] 魏颖[1] 刘怡[1] 张波[1] 郝楠馨[1] 陈明[1] 

机构地区：[1]同济大学附属东方医院医学超声科,上海200120

出　　处：《中国医学影像技术》2017年第4期529-533,共5页Chinese Journal of Medical Imaging Technology

基　　金：上海市卫生和计划生育委员会科研课题面上项目(201440335);东方起航计划科研项目青年基金(DFQH-Q16)

摘　　要：目的采用对比增强流场(CEFF)技术观察2型糖尿病(T2DM)患者颈动脉窦区壁面剪应力(WSS)的分布规律。方法选取47例T2DM患者和25名健康志愿者(对照组),并根据颈总动脉内中膜厚度(IMT)将T2DM患者分为IMT正常组(n=21)和IMT增厚组(n=26),采用CEFF分析软件,计算颈动脉窦区WSS,绘制相应WSS空间分布图,记录颈内动脉起始段后壁WSS值并进行统计学分析。结果 3组颈动脉窦区均存在两个低WSS区和一个高WSS区:颈总动脉远端至颈内动脉起始段后壁存在大范围低WSS区,颈总动脉远端前壁存在小范围低WSS区,颈内动脉起始段前壁为高WSS区。IMT正常组[(3.39±0.60)dyne/cm^2]和IMT增厚组[(2.58±0.46)dyne/cm^2]患者颈内动脉后壁WSS值均较对照组[(3.74±0.53)dyne/cm^2]显著减低(P均<0.05);IMT增厚组较IMT正常组减低(P<0.05)。结论 CEFF图像技术可初步定量检测动脉WSS,有望早期、可视化评估颈动脉硬化。Objective To investigate the application of wall shear stress （WSS） in the carotid sinus of type 2 diabetes mellitus （T2DM） patients, and analyze the spatial distribution of WSS with contrast enhanced flow field （CEFF） quantitative visualization analysis software. Methods Totally 47 T2DM patients and 25 healthy subjects were investigated. According to the intima-media thickness （IMT） of common carotid artery （CCA）, the T2DM patients were divided into IMT normal group （n=21） and IMT thickening group （n=26）. WSS in the carotid sinus was calculated by CEFF analysis software, the corresponding spatial distribution maps of WSS were designed. WSS of the posterior wall of internal carotid artery （ICA） was recorded and statistical analysis. Results Both in the carotid sinus of healthy subjects and T2DM patients, there were two low WSS regions and one high WSS region. There were a large region of low WSS at the posterior wall of CCA and ICA, a small region of low WSS at the anterior wall of CCA, and a high WSS region at the anterior wall of ICA. The WSS at the posterior wall of ICA both in the IMT normal group[（3.39±0.60）dynes/cm2] and IMT thickening group[（2.58±0.46）dynes/cm2] were significantly lower than that in control group （[3.74±0.53]dynes/cm2, both P〈0.05）. WSS in IMT thickening group was lower than that in IMT normal group （P〈0.05）. Conclusion CEFF quantitative visualization analysis might constitute an approach to assess the presence of early-stage arteriosclerosis by measuring the WSS in the carotid sinus.

关 键 词：颈动脉 壁面剪应力 糖尿病 2型 对比增强流场 超声检查 造影剂 

分 类 号：R587.1[医药卫生—内分泌] R445.1[医药卫生—内科学]