超声造影分期诊断大动脉炎

Contrast-enhanced ultrasound in classification of Takayasu ateritis

目的探讨CEUS分期诊断大动脉炎的应用价值。方法将15例大动脉炎患者按照临床标准分为活动期组和非活动期组,以二维超声和CEUS分别测量颈总动脉外径(D1、D2)和内膜厚度(d1、d2);用QLab软件对增厚内膜滋养动脉的造影剂信号行伽马回归曲线拟合,记录平均回声强度(EM)、峰值强度(DPI)、曲线下面积(AUC)、强度值(A)及抵消背景组织后强度值(C),比较两组差异。分别对CEUS所获D2和d2与EM、DPI、A及C进行相关性分析。结果活动期组颈总动脉外径和内膜厚度均大于非活动期组(P<0.05),其EM、DPI、A及C均高于非活动期组(P均<0.05);EM与D2、DPI与d2均呈正相关(r=0.871、0.508,P均<0.05)。结论 CEUS对临床分期诊断大动脉炎有较高参考价值。

Objective To explore the diagnostic value of CEUS for the classification of Takayasu arteritis （TA）. Methods CEUS characteristics were retrospectively analyzed in 15 patients with TA. The patients were divided into active group and inactive group according to clinical findings. Vessel diameter （D1, D2） and vascular wall thickness （d1, d2） were measured with the two-dimensional ultrasound and CEUS, respectively. The ROI in the dynamic images was chosen to carry out Gamma-Variate curve fitting through QLab software and made a quantitative analysis. The parameters, including echo mean （EM）, derived peak intensity （DPI）, area under curve （AUC）, intensity values （A） and intensity values after offset background organization （C） were measured with QLab. Differences of the parameters were evaluated between the two groups. The correlation between D2, d2 and EM, DPI, A, C was analyzed when CEUS was performed. Results The diameter of common carotid artery and the thickness of endometrium in activity group were greater than those of the inactivity group （both P〈0.05）. EM, DPI, A and C in active group increased compared with in inactive group （all P〈0.05）. EM and D2, DPI and d2 had positive correlation （r=0. 871, 0. 508, both P〈0.05）. Conclusion CEUS has high reference value to the clinical staging of TA.