超声弹性成像技术评估急性脑梗死颈动脉粥样硬化斑块稳定性

Real-time ultrasound elastography in evaluating carotid atherosclerosis plaques

目的探讨应用超声弹性成像技术评估急性脑梗死患者颈动脉粥样硬化斑块稳定性,并进行早期预测。方法选取2016年1-9月医院行颈动脉超声检查的急性脑梗死住院患者60例为急性脑梗死组,另选取门诊非急性脑梗死患者55例为对照组,采集两组患者基线资料,探查并测量颈动脉内膜厚度(intima media thickness,IMT)及斑块回声,采集相关的弹性参数(如弹性评分、弹性面积比值等)的数据并进行统计学分析。结果急性脑梗死组IMT明显厚于对照组(1.71±0.20 vs 1.34±0.27,P<0.05);二维灰阶超声低回声斑块、等回声斑块、混合回声斑块、强回声斑块数量两组之间未出现统计学差异(P>0.05);超声弹性评分低回声斑块和混合回声斑块急性脑梗死组明显低于对照组(1.22±0.43 vs 1.73±0.78,P=0.033;2.95±0.51 vs 3.38±0.59,P=0.036);超声斑块弹性面积比值低回声斑块与混合回声斑块急性脑梗死组明显低于对照组(1.15±0.09 vs 1.23±0.10,P=0.029;1.44±0.12 vs 1.55±0.09,P=0.010)。结论应用超声弹性成像技术可以区别出颈动脉斑块的稳定性,为急性脑梗死提供预测价值。

Objective To assess the stability of carotid atherosclerosis plaques by ultrasound elastography imaging in order to predict acute cerebral infarction.Methods Sixty in-patients with acute cerebral infarction were enrolled between January and September in 2016(acute cerebral infarction group),while another 55 out-patients undergoing cervical vascular examination in the Affiliated Hospital of People’s Armed Police Logistics University served as the control group.The baseline data of the two groups was collected as well,including BMI,disease history,blood pressure and results of biochemical tests.The carotid intima media thickness(IMT)and plaque echo features were observed using conventional 2 D ultrasound methods.The associated elastic parameters(e.g.elastic score,elastic area ratio)were acquired from the plaques’elastic dynamic image information through real-time elastography.Statistical analysis was performed.Results IMT in the acute cerebral infarction group(1.71±0.20)was significantly higher than in the control group(1.34±0.27)(P<0.05).The low echo plaque elastic score and the mixed echo plaque elastic score were both significantly lower in the control group than in the acute cerebral infarction group(1.22±0.43 vs 1.73±0.78,P=0.033;2.95±0.51 vs 3.38±0.59,P=0.036,respectively).The low echo plaque elastic area ratio and mixed echo plaque elastic area ratio were both significantly lower in the acute cerebral infarction group than in the control group(1.15±0.09 vs 1.23±0.10,P=0.029;1.44±0.12 vs 1.55±0.09,P=0.010,respectively).Conclusions The stability of carotid artery plaques can be identified by ultrasound elastography imaging to predict acute cerebral infarction.