定量超声纹理分析方法在不同心动周期评估颈动脉斑块易损性的效果研究  

Effect of cardiac cycle on quantitative ultrasonic texture analysis in evaluation of carotid plaque vulnerability

作　　者：王博逸 唐礼江[2] 洪勇强[1] 余红萍[1] 谢飞 徐洁 李铮 WANG Boyi;TANG Lijiang;HONG Yongqiang;YU Hongping;XIE Fei;XU Jie;LI Zheng(Department of Ultrasonography,Zhejiang Hospital,Hangzhou 310013,China)

机构地区：[1]浙江医院超声诊断科,杭州310013 [2]浙江医院心血管内科,杭州310013 [3]浙江医院内分泌科,杭州310013

出　　处：《浙江医学》2020年第22期2425-2428,I0002,共5页Zhejiang Medical Journal

基　　金：浙江省科技厅重大研发计划项目(2017C03034)。

摘　　要：目的探讨定量超声纹理分析方法在不同心动周期评估颈动脉斑块易损性的效果。方法选取2019年1至6月在浙江医院行颈动脉超声和心电图检查并诊断为颈动脉粥样斑块形成的糖尿病患者33例(共56个斑块),每个斑块选择3个连续心动周期,分别对在R波(舒张末期)和T波结束(收缩末期)相对应的6幅图像进行斑块纹理分析[包括灰度中值(GSM)、粗糙度、变异系数(CV)]的影响,以此判断斑块的易损性。结果收缩期未标准化GSM的均值较舒张期略高(P<0.05)。收缩期标准化GSM的CV较舒张期略高(P<0.05)。收缩期粗糙度均值大于舒张期,而CV小于舒张期(均P<0.01)。低回声斑块(GSM≤68,12.6%)的CV高于高回声斑块(GSM>68,7.5%)(P<0.01)。与舒张期相比,收缩期低回声斑块的GSM、CV均较高(均P<0.05),而收缩期和舒张期高回声斑块则均无统计学差异(均P>0.05)。有28.6%(16/56)的斑块易损性结果发生了改变。结论采用定量超声纹理分析在舒张末期进行颈动脉斑块测量,对斑块易损性的鉴别准确性更高。Objective To investigate the effect of cardiac cycle on quantitative ultrasonic texture analysis(QUS)in evaluation of carotid plaque vulnerability.Methods A total of 397 patients with diabetes underwent carotid ultrasound and electrocardiogram(ECG)examination in Zhejiang Hospital between January 2019 and June 2019,and 33 cases were diagnosed as carotid artery atheromatous plaque(56 plaques).Three consecutive cardiac cycles were chosen for each plaque,texture image analysis was performed on the R wave(end-diastolic)and T wave end systolic to determine plaque vulnerability.Results The non-standardized GSM of the systolic mean was higher than that of the diastolic mean(P<0.05).The standardized GSM of the systolic CV was higher than that of diastolic CV(P<0.05).The mean value of systolic period was greater than that of diastolic period,and CV of systolic period was smaller than that of diastolic period(P<0.01).The CV of hypoechoic plaque(GSM≤68,12.6%)was higher than that of hyperechoic plaque(GSM>68,7.5%,P<0.01).Hypoechoic plaques had higher GSM and variability in systolic period than in diastolic period(P<0.05),while there was no significant difference for hyperechoic plaque between systolic and diastolic phases(P>0.05).The results of plaque vulnerability measurement showed a variation in 28.6%plaques(16/56)between systolic and diastolic phases of cardiac cycle.Conclusion The identification of plaque vulnerability by end-diastolic plaque measurement and quantitative ultrasonic texture analysis is more accurate.

关 键 词：颈动脉斑块 心动周期 纹理分析 回声性质 

分 类 号：R587.2[医药卫生—内分泌] R743[医药卫生—内科学]