实时三维超声技术评价下肢动脉粥样硬化病变:与64层螺旋CT三维重建技术对比观察

Real-time three-dimensional ultrasonographic evaluation of the lower-extremity arteriosclerosis obliterans:compared with 64 multi-slice spiral CT 3D angiography

目的探讨实时三维超声技术(RT-3DU)评价下肢动脉粥样硬化斑块在定性和定量方面的应用价值,并与64层螺旋CT三维重建技术相对比。方法对70例下肢动脉粥样硬化患者进行实时三维超声以及下肢动脉CT三维重建检查,进行影像学对比分析。结果RT-3DU以及3D-CTA均可显示斑块的位置、管壁结构和管腔狭窄程度。RT-3DU可明确显示斑块的回声强度及其在血流冲击下的活动度,最大斑块处管腔狭窄率测量结果(86.52±2.30)%与3D-CTA(89.36±1.74)%比较差异无统计学意义(P>0.05),相关性良好(r=0.90,P<0.01);二者在斑块识别以及管腔的狭窄程度判断上一致性较高(Kappa值为0.80,P<0.05)。结论实时三维超声可较好地定性评价下肢动脉粥样硬化斑块,并具有能定量评价斑块、价廉、无创的独特优势,具有较高的临床应用价值。

Objective To explore the value of real-time three-dimension （RT-3D） ultrasonography in quantitative and qualitative diagnosis of lower-extremity arteriosclerosis obliterans, and to compare RT-3D with 64 multi-slice spiral CT 3D angiography （3D-CTA）. Methods Seventy patients with lower-extremity arteriosclerosis obliterans were examined by both RT- 3D ultrasonography and 3D-CTA, and the results were analyzed comparatively. Results RT-3D ultrasonography and 3D- CTA displayed clearly the location of atherosclerotic plaques, the structure of vessel wall and the extent of the stenosis. RT- 3D ultrasonography showed the echo and the mobility of plaque in the blood vessl. There was a high correlation between RT- 3D ultrasonography and 3D-CTA in the rate of stenosis （86.52±2.30）% and （89.36± 1.74）%, （r=0.90, P〈0.01）, while the identification of plaques and the extent of stenosis with RT-3D ultrasonography and 3D-CTA had the better concordance according to the value of Kappa 0. 80 （P〈0. 05）. Conclusion RT-3D ultrasonography can evaluate lower-extremity arteriosclerosis obliterans in quality. As a cheap, non-invasive evaluation method, RT-3D ultrasonography is of high clinical value in practice.