本文選題：超聲檢查　切入點：頸動脈粥樣硬化斑塊　出處：《寧夏醫(yī)科大學》2014年碩士論文

【摘要】：目的探討彈性成像技術面積比值法在頸動脈斑塊診斷中的應用價值，并應用實時超聲彈性成像量化值（面積比）評價腦梗死患者頸動脈斑塊，探討彈性成像技術評價頸動脈斑塊穩(wěn)定性的價值。 方法對75例門診患者頸動脈行常規(guī)超聲檢查，檢測其斑塊部位、數(shù)量、大小及回聲強度，切換至彈性成像模式進行實時觀察斑塊，圖像顯示清晰且QF達到60及以上時凍結圖像，分別勾畫斑塊在二維圖和彈性圖的區(qū)域，勾畫三次，取平均值，儀器分別自動測出所勾畫的面積，并計算彈性比值（面積比=彈性圖面積/二維圖面積，即A2/A1）。 在上述研究結果分析基礎上，采用常規(guī)超聲檢查45例腦梗死患者頸動脈，首先確定有無斑塊及斑塊部位、大小及回聲強度，超聲確定斑塊后，切換至彈性成像模式進行實時觀察斑塊，用同樣方法計算斑塊彈性比值（面積比=彈性圖面積/二維圖面積，即A2/A1）。 結果在75例門診患者中，二維超聲檢出頸動脈斑塊共計52處，76.92%位于頸總動脈分叉處（40/52），其中低回聲斑塊35處，高回聲斑塊11處，不均質回聲斑塊8處；彈性成像檢出46處斑塊，檢出率為88.4%（46/52）；低回聲斑塊、不均質回聲斑塊、高回聲斑塊二維與彈性成像面積比值依次增大,差異有高度統(tǒng)計學意義（P=0.001, P0.05），余兩兩之間有統(tǒng)計學意義（P0.05）。 分析45例腦梗死患者結果，其中12例無斑塊，余33例常規(guī)超聲檢測到35處頸動脈粥樣硬化斑塊，其中低回聲斑塊4處、等回聲斑塊5處、高回聲斑塊11處，不均質回聲斑塊15處；低回聲斑塊、不均質回聲斑塊、等回聲斑塊、高回聲斑塊彈性比值依次增大,差異有統(tǒng)計學意義（P=0.001, P0.05）；低回聲和不均質回聲之間無統(tǒng)計學意義（P=0.15, P0.05），等回聲和不均質回聲之間無統(tǒng)計學意義（P=0.763，P0.05），余兩兩之間有差異，，有統(tǒng)計學意義（P0.05）。 結論超聲彈性成像技術可用于評價頸動脈斑塊硬度，不同組織聲學特性的斑塊面積比值不同，可以作為斑塊穩(wěn)定性判斷的較好指標，對臨床缺血性腦病的預防和診治有重要意義。
[Abstract]:Objective to evaluate the value of area ratio of elastic imaging technique in the diagnosis of carotid plaques, and to evaluate carotid plaques in patients with cerebral infarction by using the quantitative value (area ratio) of real-time elastography.To evaluate the value of elastic imaging in evaluating the stability of carotid plaques.Methods the carotid artery of 75 outpatients was examined by conventional ultrasound. The location, number, size and echo intensity of the plaque were detected. The plaque was observed in real time by using elastic imaging mode. The frozen image showed clearly and the QF reached 60 or above.The plaques are drawn in the region of two dimensional and two dimensional maps respectively, drawing three times, taking the average value, measuring the area drawn by the instrument automatically, and calculating the elastic ratio (area ratio = the area of the elastic diagram / the area of the two-dimensional map, that is, A _ 2 / A _ 1 ~ (1)).On the basis of the analysis of the above results, 45 patients with cerebral infarction were examined by conventional ultrasound. The plaque and its location, size and echo intensity were first determined, and the plaque was determined by ultrasound.The patch was observed in real time by switching to elastic imaging mode, and the elastic ratio of patch (area ratio = elastic map area / two-dimensional map area) was calculated by the same method.Results in 75 outpatients, 52 carotid plaques were detected by two-dimensional ultrasound, 76.92% of them were located at the bifurcation of common carotid artery, 35 hypoechoic plaques, 11 hyperechoic plaques, 8 heterogeneous plaques, 46 plaques were detected by elastic imaging.The detectable rate was 88.4 / 52, and the ratio of hypoechoic plaques, non-echoic plaques and hyperechoic plaques to elastic imaging area increased in turn, the difference was statistically significant (P < 0.001), P 0.05 (P 0.05), and P 0.05 (P 0.05).The results of 45 patients with cerebral infarction were analyzed, including 12 cases without plaque, and 33 cases with 35 carotid atherosclerotic plaques, including 4 hypoechoic plaques, 5 isoechoic plaques, 11 hyperechoic plaques.The elastic ratio of hypoechoic plaques, hypoechoic plaques, isoechoic plaques and hyperechoic plaques increased in turn.Conclusion Ultrasound elastic imaging can be used to evaluate the carotid plaque hardness, and the plaque area ratio of different tissue acoustic characteristics is different, which can be used as a better index to judge the plaque stability.It is of great significance for the prevention, diagnosis and treatment of ischemic encephalopathy.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R445.1;R743.3

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