三维超声血管斑块定量分析技术诊断颈动脉血管狭窄及斑块特征的应用

景江新; 陈胜国; 霍昱彰; 塔娜; 钟小兰

doi:10.12125/j.chj.202104018

三维超声血管斑块定量分析技术诊断颈动脉血管狭窄及斑块特征的应用

Application of three-dimensional ultrasound vascular plaque quantitative analysis technology in diagnosis of carotid artery stenosis and plaque characteristics

摘要

摘要:
目的探讨实时三维超声（real-time 3D ultrasound，RT-3DU）血管斑块定量分析（vascular plaque quantification，VPQ）技术诊断颈动脉血管狭窄及斑块特征的应用。
方法对2020年1月~2021年1月于新疆医科大学第七临床医学院接受RT-3DU检查的颈动脉斑块患者40例（颈动脉斑块共57处）进行分析，应用RT-3DU VPQ技术检测颈动脉相关参数，同时应用动脉CT血管造影术检测颈动脉狭窄程度，比较分析两种方式诊断颈动脉狭窄程度的一致性。
结果在40例颈动脉斑块患者中，其颈动脉内中膜厚度为（1.33 ± 0.14）mm，斑块回声强度为（36.29 ± 7.51）dB，标化壁指数（NWI）为（0.64 ± 0.18），57处颈动脉斑块厚度为（3.6 ± 0.5）mm。轻度、中度及重度狭窄组患者的NWI比较差异显著（P<0.05），且重度狭窄组患者的NWI高于轻度及中度狭窄组，中度狭窄组患者的NWI高于轻度狭窄组（P<0.05）。RT-3DU VPQ检查诊断颈动脉局部管腔存在9处轻度狭窄，43处中度狭窄，5处重度狭窄；动脉CT血管造影检查诊断颈动脉局部管腔存在6处轻度狭窄，38处中度狭窄，13处重度狭窄。RT-3DU VPQ和动脉CT血管造影检查诊断颈动脉局部管腔狭窄程度的一致性较高（Kappa=0.819）。
结论对于颈动脉斑块患者，应用RT-3DU VPQ技术可测定其血管狭窄程度，还可量化分析斑块回声强度、累及部位血管负荷变化。

Abstract:
AIM To explore the application of real-time 3D ultrasound (RT-3DU) vascular plaque quantification (VPQ) technology to diagnose carotid artery stenosis and plaque characteristics.
METHODS A retrospective analysis was made in 40 carotid plaque patients (57 carotid plaques in total) who underwent real-time three-dimensional ultrasound examination in our hospital from January 2020 to January 2021. Real-time three-dimensional ultrasound VPQ technology was used to detect carotid artery related parameters and arterial CT angiography was used to detect the degree of carotid artery stenosis. The consistency of the two methods for diagnosing carotid artery stenosis was compared and analyzed.
RESULTS In the 40 patients with carotid artery plaque, the thickness of the carotid artery intima-media was (1.33 ± 0.14)mm, the plaque echo intensity was (36.29 ± 7.51)dB and the NWI was (0.64 ± 0.18) and in the 57 carotid plaques, the block thickness was (3.6 ± 0.5) mm. The NWI of patients in the mild stenosis group, moderate stenosis group and severe stenosis group was significantly different (P<0.05). The NWI in the severe stenosis group was higher than that in the mild and moderate stenosis groups and the NWI in the moderate stenosis group was higher than that in the mild stenosis group (P<0.05). Nine mild stenosis, 43 moderate stenosis and 5 severe stenosis were diagnosed by real-time three-dimensional ultrasound VPQ examination in the local carotid lumen and 6 mild stenosis, 38 moderate degree stenosis and 13 severe stenosis were diagnosed by arterial CT angiography in the local carotid lumen. Real-time three-dimensional ultrasound VPQ and arterial CT angiography had a high consistency in the diagnosis of local carotid lumen stenosis (Kappa=0.819).
CONCLUSION For patients with carotid plaque, the application of real-time three-dimensional ultrasound VPQ technology can not only determine the degree of vascular stenosis, but can also quantitatively analyze the echo intensity of the plaque and the changes in the vascular load of the involved parts.

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