超声弹性成像技术对颈动脉斑块稳定性的诊断价值  

Diagnostic value of elastic ultrasound in the stability of carotid plaque

作　　者：陈西蜀[1] 周洋[1] 叶鸣[1] 王弼偲[2] Chen Xishu;Zhou Yang;Ye Ming;Wang Bisi(Department of Ultrasound Imaging,Chengdu Third People's Hospital,Chengdu 610031,Sichuan,China;Department of Interventional Vascular Center,Chengdu Third People's Hospital,Chengdu 610031,Sichuan,China)

机构地区：[1]成都市第三人民医院超声影像科,四川成都610031 [2]成都市第三人民医院介入血管中心,四川成都610031

出　　处：《血管与腔内血管外科杂志》2021年第6期737-741,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨超声弹性成像技术对颈动脉斑块稳定性的诊断价值。方法收集2018年1月至2021年1月成都市第三人民医院收治的相关病例资料,以43例急性脑梗死(ACI)患者作为不稳定组,以59例颈动脉斑块患者作为稳定组。比较两组患者的剪切波弹性超声参数(最小弹性模量值、最大弹性模量值、平均弹性模量值)和应变性弹性成像参数[应变率(B/A)、组织弹性成像评分]。比较两组患者的弹性超声下斑块特征(血管狭窄、纤维帽完整、钙化、出血发生率)。以数字减影血管造影(DSA)结果为金标准,分析超声弹性成像诊断颈动脉斑块的稳定性与金标准的一致性,计算诊断价值与各项诊断指标。结果不稳定组患者的最小弹性模量值、最大弹性模量值、平均弹性模量值均明显高于稳定组患者,B/A明显低于稳定组患者,差异均有统计学意义(P<0.01)。不稳定组患者的组织弹性成像评分整体低于稳定组患者,差异有统计学意义(P=0.002)。不稳定组患者血管狭窄、出血的发生率均高于稳定组患者,纤维帽完整、钙化的发生率均低于稳定组患者,差异均有统计学意义(P<0.05)。超声弹性成像对颈动脉斑块稳定性的诊断结果与金标准具有高度一致性(P<0.01);诊断灵敏度为97.67%,特异度为89.83%,准确度为93.14%。受试者工作特征(ROC)曲线及曲线下面积(AUC)分析结果显示,超声弹性成像技术对颈动脉斑块的稳定性具有较高的诊断价值AUC=0.938(95%CI:0.885~0.990)(P<0.05)。结论超声弹性成像技术对颈动脉斑块的稳定性具有较高的诊断价值,能够为临床治疗提供数据支持。Objective To investigate the diagnostic value of ultrasound elastography in the stability of carotid plaque.Method Data of related cases admitted to Chengdu Third People's Hospital from January 2018 to January 2021 were retrospectively analyzed.Forty-three patients with acute cerebral infarction(ACI)were taken as the unstable group,and fifty-nine patients with carotid plaque were taken as the stable group.Shear-wave elastography parameters(minimum elastic modulus,maximum elastic modulus,mean elastic modulus)and deformation elastography parameters[strain rate(B/A)value,tissue elastography score],plaque characteristics under elastography(vascular stenosis,fibrous cap integrity,calcification,bleeding incidence)were compared between the two groups.With the result of digital substraction angiography(DSA)as the gold standard,the consistency between the stability of carotid plaque diagnosed by elastic ultrasound and the gold standard was analyzed,and the diagnostic value and various diagnostic indicators were calculated.Result The minimum elastic modulus,maximum elastic modulus,mean elastic modulus in the unstable group were higher than those in the stable group,and the B/A was lower than that in the stable group,with statistical significance(P<0.01).The total tissue elastography score of the unstable group was lower than that of the stable group,and the difference was statistically significant(P=0.002).The incidence rate of vascular stenosis and bleeding in the unstable group was higher than that in the stable group,and the incidence rate of fibrous cap integrity and calcification was lower than that in the stable group,with statistical significance(P<0.05).The diagnostic results of carotid plaque by elastic ultrasound were highly consistent with the gold standard(P<0.01).The diagnostic sensitivity,specificity and accuracy were 97.67%,89.83%and 93.14%respectively.Receiver operating characteristic(ROC)curve analysis showed that elastic ultrasound had high diagnostic value for the stability of carotid plaque area under t

关 键 词：超声弹性成像 颈动脉斑块 急性脑梗死 稳定性 诊断价值 

分 类 号：R543[医药卫生—心血管疾病]