三维超声联合灰阶超声造影在急性冠状动脉综合征诊断中的应用  

Application of three-dimensional ultrasound combined with gray-scale ultrasound in the diagnosis of acute coronary syndrome

作　　者：葛建丽[1] 徐更田[1] 赵晓[1] 石霄杰 何好超 Ge Jianli;Xu Gengtian;Zhao Xiao;Shi Xiaojie;He Haochao(Department of Ultrasound,Puyang Oil Field General Hospital,Puyang 457001,China)

机构地区：[1]河南省濮阳市油田总医院超声科,457001

出　　处：《中国实用医刊》2020年第20期46-49,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨三维超声联合灰阶超声造影(CEUS)在急性冠状动脉综合征(ACS)诊断中的应用价值。方法抽取濮阳市油田总医院2018年7月至2020年3月113例因胸痛就诊、经临床诊断为冠心病伴颈动脉及股动脉斑块患者,所有患者均接受心电图、冠状动脉造影、心肌肌钙蛋白(cTnI)检查。参照相关诊断标准,结合临床检查结果将ACS患者纳入ACS组,其他患者纳入非ACS组。全部患者均接受三维超声联合灰阶CEUS检查,比较两组颈动脉、股动脉斑块最大面积、最大体积、造影强度(EI)值、斑块灰阶强度(EL)值,分析颈动脉与股动脉EI值、EL值用于ACS的诊断价值。结果113例患者经诊断43例为ACS,占38.05%;ACS组与非ACS组颈动脉、股动脉斑块最大面积、斑块最大体积比较,差异未见统计学意义(P>0.05);ACS组颈动脉、股动脉EI值高于非ACS组,EL值低于非ACS组,差异有统计学意义(P<0.05);绘制受试者工作特征曲线结果显示,颈动脉EI值、EL值用于诊断ACS的曲线下面积分别为0.887、0.891,股动脉EI值、EL值诊断ACS的曲线下面积分别为0.953、0.961,均>0.85,均有较好的诊断价值。结论三维超声联合灰阶CEUS可经评估颈动脉、股动脉斑块强度预测ACS风险,该联合方案用于诊断ACS有较高价值。Objective To explore the value of three-dimensional ultrasound combined with gray-scale ultrasound contrast(CEUS)in the diagnosis of acute coronary syndrome(ACS).Methods A total of 113 patients in Puyang Oil Field General Hospital from July 2018 to March 2020 who were diagnosed with chest pain and clinically diagnosed as coronary heart disease with carotid and femoral plaques were selected,and all patients underwent electrocardiogram,coronary angiography,and cardiac troponin(cTnI)examination.According to relevant diagnostic criteria,combined with clinical examination results,ACS patients were included in the ACS group,and other patients were included in the non-ACS group.All patients underwent three-dimensional ultrasound combined with gray-scale CEUS examination,the carotid artery,femoral artery plaque maximum area,maximum volume,contrast intensity(EI)value,plaque grayscale intensity(EL)value were compared between the two groups,the carotid artery and femoral artery EI value,EL value for the diagnostic value of ACS were analyzed.Results Among 113 patients,43 cases were diagnosed as ACS,accounting for 38.05%;the largest area of carotid artery and femoral plaque and the largest volume of plaque were compared between ACS group and non-ACS group,the differences were not statistically significant(P>0.05);the EI value of the carotid artery and femoral artery in the ACS group was higher than that in the non-ACS group,and the EL value was lower than that in the non-ACS group,the differences were statistically significant(P<0.05);the results of drawing the receiver operating characteristic curve curve showed that the area under the curve of carotid artery EI and EL values used to diagnose ACS were 0.887 and 0.891,respectively,and the area under the curve of femoral artery EI value and EL value used to diagnose ACS were 0.953 and 0.961,respectively,both>0.85,which had good diagnostic value.Conclusions Three-dimensional ultrasound combined with gray-scale CEUS can predict the risk of ACS by evaluating the plaque strength o

关 键 词：急性冠脉综合征 三维超声 灰阶超声造影 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]