声辐射力脉冲成像技术检测不同类型颈动脉斑块硬度的临床研究

Detection of hardness for different type of carotid plaques using acoustic radiation force impulse imaging technique

目的探讨声辐射力脉冲成像(ARFI)技术在定量评价不同类型颈动脉斑块硬度的价值。方法选取我院伴有颈动脉斑块的健康体检者106例,共计141个斑块;根据二维超声特点将其分为软斑61个、混合斑39个及硬斑41个,ARFI技术检测不同类型斑块的剪切波传播速度(SWV)和斑块厚度,并对其进行对比分析;绘制受试者工作特征曲线图,筛选SWV诊断混合斑和硬斑的最佳临界值。结果三种斑块SWV比较差异有统计学意义(P<0.01),其中软斑SWV最慢,硬斑SWV最快;ROC曲线分析显示,SWV诊断混合斑和硬斑的最佳临界值分别为1.57 m/s、2.14 m/s。结论 ARFI技术可为斑块稳定性的判断提供较为可靠的定量指标,具有一定的临床意义。

Objective To evaluate the hardness quantitatively for different type of carotid plaques using ARFI technique. Methods Data of 106 patients with 141 carotid plaques were enrolled in this study. According to the two-dimensional ultrasound,141 carotid plaques were divided into 61 soft-plaques,39 mixed-plaques and 41 hard-plaques. The shear wave velocity（SWV）and plaque thickness of different type of carotid plaques were compared and analyzed. The ROC curve was depicted and used to evaluate plaques hardness. Result The SWV was statistically different among three types of carotid plaques（P〈0.01）,the SWV of the sofe-plaque was the slowest,and the SWV of the hard-plaque was the fastest. The critical value of SWV for mixed-plaque and hard-plaque were 1.57 m/s and 2.14 m/s by ROC curve,respectively. Conclusion ARFI is a potential quantitative index to evaluate the stability of carotid plaques,which is helpful in clinic diagnosis.