| 李婵娟.实时三维超声血管斑块定量分析评价颈动脉斑块易损性的研究[J].浙江中西医结合杂志,2022,32(4): |
| 实时三维超声血管斑块定量分析评价颈动脉斑块易损性的研究 |
| Evaluation value and feasibility analysis of three-dimensional ultrasound vascular plaque quantification technology in quantitative evaluation of carotid plaque |
| 投稿时间：2021-10-15 修订日期：2022-01-19 |
| DOI： |
| 中文关键词: 颈动脉斑块 三维超声 血管斑块定量分析 诊断价值 |
| 英文关键词:Carotid plaque Three-dimensional ultrasound Vascular plaque quantification technology Diagnostic value |
| 基金项目:浙江省医药卫生科技计划项目2019AD32145 |
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| 中文摘要: |
| 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）技术诊断颈动脉斑块性质及狭窄程度的临床价值。方法：回顾性选取2020年6月至2020年12月于我院接受颈动脉斑块性质检查的患者108例，所有研究对象均应用RT-3DU VPQ技术检测颈动脉相关参数，并于超声检查后24h内进行CEA手术和病理学诊断，比较各参数的差异并构建标准化管壁指数（Normalized Wall Index，NWI）及建灰阶中位数（Gray Scale Median，GSM）的受试者工作特征(Receiver Operating Characteristic,ROC)曲线,评价其诊断价值。结果：108例患者共发现115个颈动脉斑块，经病理组织学诊断，易损斑块64个，稳定斑块57个。易损斑块与稳定斑块的斑块厚度、体积和最大面积狭窄率之间的差异无统计学意义（P>0.05），易损斑块的NWI值（0.68±0.14）高于稳定斑块（0.56±0.11），易损斑块的GSM值（29.61±10.88）低于稳定斑块（50.95±17.62），差异均具有统计学意义（P<0.05）；血管不同狭窄程度者的IMT、最窄处斑块厚度和斑块回声强度之间的差异无统计学意义（P>0.05）；但血管不同狭窄程度者的NWI值差异具有统计学意义（P<0.05）；中度狭窄者的NWI值高于轻度狭窄，重度狭窄者的NWI值高于轻度和重度狭窄的患者。以GSM值34诊断易损斑块的灵敏度为78.69%，特异度为81.48%，准确度80.0%，阳性预测值为82.76%，阴性预测值为77.19%，ROC曲线下面积为0.745。以NWI值0.641诊断易损斑块的的灵敏度为63.93%，特异度为79.63%，准确度为66.09%，阳性预测值为78.0%，阴性预测值为66.15%，ROC曲线下面积为0.706。结论：RT-3DU VPQ技术利用GSM和NWI有助于更客观评估斑块成分、血管负荷,对于斑块性质及狭窄程度的诊断具有临床应用价值。 |
| 英文摘要: |
| Ａbstract Objective: To investigate the clinical value of real-time 3D ultrasound (rt-3du) in the diagnosis of carotid plaque. Methods: from June 2020 to December 2020, 108 patients with carotid plaques underwent rt-3du examination in our hospital. All subjects were detected carotid artery related parameters by rt-3du vpq technology, and CEA operation and pathological diagnosis were performed within 24 hours after ultrasound examination. The differences of each parameter were compared and the normalized wall index (NWI) was constructed, NWI) and receiver operating characteristic (ROC) curve of gray scale medium (GSM) were constructed to evaluate the diagnostic value. Results: a total of 115 carotid plaques were found in 108 patients, including 64 vulnerable plaques and 57 stable plaques. The NWI value of vulnerable plaque (0.68 ± 0.14) was higher than that of stable plaque (0.56 ± 0.11), while the GSM value of vulnerable plaque (29.61 ± 10.88) was lower than that of stable plaque (50.95 ± 17.62), the difference was statistically significant (P < 0.05); The difference of NWI in patients with different degree of stenosis was statistically significant (P < 0.05); The sensitivity of GSM value of 34 was78.69%, 81.48%, 80.0%, 82.76%, 77.19% and 0.745 respectively. The sensitivity of NWI value of 0.641 was 63.93%, 79.63%, 66.09%, 78.0%, 66.15% and 0.706 respectively. Conclusion: rt-3du vpq technology using GSM and NWI is helpful to more objective assessment of plaque composition and vascular load, and has important value in the diagnosis of plaque nature and stenosis degree. |
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