血管内超声虚拟组织学成像在诊断颈动脉狭窄斑块性质与狭窄程度相关性的价值分析  

Value of Intravascular Ultrasound Virtual Histology Imaging in Diagnosis of Carotid Plaque and Degree of Stenosis

作　　者：赖穗翩[1] 陈钜涛 黎冠东[1] 彭宇程[1] 伍振富[1] 叶杰明[1] LAI Suipian;CHEN Jutao;LI Guandong(Jiangmen Central Hospital,Jiangmen 529071,China)

机构地区：[1]广东省江门市中心医院,广东江门529071

出　　处：《中国医学创新》2018年第28期5-10,共6页Medical Innovation of China

基　　金：江门市医疗卫生领域科技计划项目(2015002)

摘　　要：目的:应用血管内超声虚拟组织学成像(VH-IVUS)对颈动脉狭窄斑块性质以及狭窄程度的相关性的诊断价值进行研究。方法:选择2015年6月-2017年6月本院收治的颈动脉狭窄患者30例为研究对象。通过IVUS检查,明确患者颈动脉狭窄斑块的性质与狭窄程度。按照管腔狭窄程度将其分为轻度狭窄组(狭窄程度≤50%)、中度狭窄组(狭窄程度50%~69%)及重度狭窄组(狭窄程度≥70%),分析颈动脉狭窄程度与斑块性质的相关性。结果:三组狭窄管腔面积、斑块面积及斑块负荷越来越重(P<0.05),而外弹力膜横截面积越来越小(P<0.05)。重度狭窄组有更大的纤维组织面积(P>0.05),而轻度狭窄组钙化组织面积及坏死核心面积更大(P<0.05),并且三组狭窄斑块中纤维组织比例越来越高(P<0.05),而钙化组织比例及坏死核心比例却越来越小(P<0.05)。相关性分析示管腔狭窄程度与纤维组织百分比呈显著正相关(r=0.694,P=0.003),而与钙化组织及坏死核心比率呈负相关(r=-0.375,P=0.011;r=-0.348,P=0.015)。轻度狭窄组斑块以薄纤维帽纤维粥样斑块瘤(TCFA)和钙化薄纤维帽纤维粥样斑块瘤(CaTCFA)为主。结论:血管内超声虚拟组织学成像能够为分析颈动脉斑块性质提供一定的依据并在诊断斑块性质和狭窄程度的相关性上具有一定的价值。Objective:To investigate the diagnostic value of the characteristics of carotid stenotic plaques and the degree of stenosis by intravascular ultrasound virtual histological imaging(VH-IVUS).Method:We selected our hospital carotid stenosis from June 2015 to June 2017,thirty patients were included in the study.After IVUS examination,we identified the nature of carotid artery stenosis and the degree of stenosis.According to the degree of luminal stenosis,they were divided into mild stenosis group(stenosis degree≤50%),moderate stenosis group(stenosis degree 50%-69%)and severe stenosis group(stenosis degree≥70%).The correlation between carotid artery stenosis and plaque properties was analyzed.Result:Three groups of narrow lumen area,plaque area and plaque load were more and more heavy(P<0.05),while the cross-sectional area of outer elastic membrane was smaller and smaller(P<0.05).Severe stenosis group had larger fibrous tissue area(P>0.05),while mild stenosis group had more calcified tissue area and necrotic core area(P<0.05),and the proportion of fibrous tissue in three groups of stenosis plaques were higher and higher(P<0.05).The proportion of calcified tissue and necrotic core were getting smaller and smaller(P<0.05).The correlation analysis showed that the degree of lumen stenosis was positively correlated with the percentage of fibrous tissue(r=0.694,P=0.003),negatively correlated with calcified tissue(r=-0.375,P=0.011)and the percentage of necrotic core(r=-0.348,P=0.015).In the mild stenosis group,fibrous fibrous atheromatous plaque(TCFA)and calcified fibrin atheromatous plaque(CaTCFA)were dominated.Conclusion:VH-IVUS can provide a basis for analyzing the properties of carotid plaque and can be used to determine the degree of plaque stenosis and the nature of plaque,and has a certain value in the diagnosis of the relationship between plaque properties and stenosis.

关 键 词：血管内超声 虚拟组织学成像 颈动脉斑块性质 颈动脉狭窄 

分 类 号：R743.3[医药卫生—神经病学与精神病学]