三维超声容积法在下肢动脉容积减少程度判定中的临床应用

Application of three-dimensional ultrasound volume method in judgement of reduction degree of lower extremity arteries volume

目的:利用三维超声容积法测定下肢主干动脉容积减少程度,并与动脉缺血性疾病的临床分期、踝肱指数(ABI)、经皮氧分压(TcPO2)测量结果进行对比,探讨三维超声容积法判定动脉容积减少程度的临床价值。方法:选取2011年3月—2012年2月于本院超声科检查的下肢动脉硬化闭塞症(ASO)患者60例,患肢均为单侧,共60条动脉,患侧髂动脉均无狭窄或闭塞;利用三维超声容积法GI3DQ技术测量选定动脉节段的血管容积,计算下肢狭窄动脉整体容积减少程度;设定下肢动脉容积相对减少30%～49%、50%～70%和大于70%为轻、中和重度组,每组20例;将三维超声容积法测定的下肢主干动脉容积减少程度与动脉缺血性疾病的临床分期、ABI及TcPO2进行相关性分析。结果:本组病例显示下肢动脉容积均有不同程度减少,减少程度与ASO临床分期有中等相关性(r=0.500,P<0.01);动脉容积减少轻度组患者ABI为0.72～0.90,中度组0.44～0.69,重度组均<0.40;动脉容积减少轻度组患者踝部TcPO2为42～50 mmHg,中度组为24～41mmHg,重度组均<22mmHg;三维超声容积法与ABI和TcPO2相关系数(R2值)分别为0.998 7和0.995 7,2组对比数据间线性相关性存在。结论:三维超声测定下肢动脉容积能够评估动脉缺血程度,可以作为评价下肢动脉缺血程度的全新、立体的无创性影像学新方法。

Objective To determine the degree of volume reduction of major arteries of lower extremities with the three-dimensional ultrasound volume method and to compare the measuring results of clinical stage,ankle-brachial index（ABI）and transcutaneous oxygen pressure（TcPO2）of arterial ischemic disease,and to explore its clinical value.Methods 60patients（March 2011-February 2012,with ultrasound examination in our hospital,unilateral limb,total of 60arteries,without ipsilateral iliac artery stenosis or occlusion）with arterial sclerosis obstruction（ASO）were selected and the vascular volumes of the selected arteries segments were measured with GI3DQ technique,then the reduction degree of overall volume of narrow lower extremity arteries was calculated.According the results of the calculation,the patients were divided into the mild（the reduction of volume 30%49%）,the moderate（the reduction of volume 50%-70%）and severe（the reduction of volume 70%）groups（n=20）and the volume reduction of major arteries of lower extremities was measured with the three-dimensional ultrasound volume method,and the statistical correlation analysis was performed with clinical stage,ABI and TcPO2.Results The patients showed reduced lower extremity arterial volume in varying degrees,the reduction extent and ASO clinical stage showed a moderate correlation（r=0.500,P0.01）.The ABI of the patients in mild group was 0.72-0.90,in moderate group 0.44-0.69,in severe group 0.40.The TcPO2 in mild group was 42-50mmHg,in moderate group 24-41 mmHg,in severe group 22 mmHg.The results showed that the correlation coefficient（R2）of three-dimensional ultrasound volume and ABI,as well as the R2 of three-dimensional ultrasound volume and TcPO2 were 0.9987and 0.9957,and there was linear correlation between the two sets of comparative data.Conclusion The three-dimensional ultrasound measurement of lower extremity arterial volume to assess the degree of arterial ischemia can be used as a new,comprehensive non-invasive imaging method in the evaluation of lower limb ischemia.