应用实时超声弹性成像（RTE）评价颈动脉斑块易损性，并探讨其评价SSS-TOAST 1型脑梗死患者病情进展价值。

选择2012年3月至2013年2月在首都医科大学附属北京天坛医院超声科常规超声检查伴有颈动脉硬化斑块形成的SSS-TOAST 1型脑梗死患者113例，为脑梗死组，及选取伴有颈部动脉硬化斑块但未患有脑梗死的患者48例为对照组，所有患者行超声弹性成像检查，比较2组间弹性成像检查结果。将脑梗死组根据梗死后病情变化分为梗死后进展组和非进展组，比较2组间弹性成像检查结果。

脑梗死组与对照组间颈动脉斑块长轴长度、斑块厚度、斑块短轴长度差异无统计学意义（t=0.62、0.88、0.33，P均> 0.05）。梗死组颈动脉斑块弹性成像以黄绿色为主，非梗死组斑块弹性成像以绿蓝色为主。脑梗死组颈动脉斑块弹性值、管壁弹性值及斑块硬度较对照组低，2组间差异有统计学意义（t=15.61、10.77、4.52，P均< 0.05）。脑梗死后进展组与非进展组间颈动脉斑块长轴长度、斑块厚度、斑块短轴长度差异无统计学意义（t=1.40、1.34、0.17，P均> 0.05）。脑梗死组中梗死后进展组比非进展组颈动脉斑块弹性值、管壁弹性值及斑块硬度低，2组间差异有统计学意义（t=6.39、2.30、3.80，P均< 0.05）。

RTE可以评价斑块的软硬度以反映斑块的易损性，SSS-TOAST 1型脑梗死组患者斑块弹性值、管壁弹性值及斑块硬度较对照组低，其易损性高；且RTE对评价梗死后病情变化有一定作用。

To evaluate the vulnerability of carotid arteriosclerosis plaque by ultrasound real-time tissue elastography in patients with SSS-TOAST 1 style cerebral infarction, and discussing the value of the technique in assessment of the clinical course after cerebral infarction.

There were 113 patients of SSS-TOAST 1 style cerebral infarction who had carotid arteriosclerosis plaque and 48 patients of contrast group who had carotid arteriosclerosis plaque selected by ultrasound in Department of Ultrasound, Beijing Tiantan Hospital, Capital University of Medical Sciences. The results between two groups were compared. The cerebral infarction group was divided into two sub-groups according to the clinical course of patients after cerebral infarction, and the difference between them was compared.

The size had no significant difference between cerebral infarction group and contrast group as well as between aggravated group and non-aggravated group (t=15.61, 10.77, 4.52, P<0.05). The real-time tissue elastography of carotid arteriosclerosis plaques were red-green in most patients of cerebral infarction group. The real-time tissue elastography of carotid arteriosclerosis plaques were green-blue in most patients of in control group. The value of elasticity of plaque, vessel wall and stiffness of carotid arteriosclerosis plaque between cerebral infarction group and control group had significant differences (t=15.61, 10.77, 4.52, P<0.05). The value of real-time tissue elastography between aggravated group and non- aggravated group had significant difference (t=6.39, 2.30, 3.80, P<0.05).

Real-time tissue elastography could evaluate the stiffness of carotid arteriosclerosis plaque, which was related with the vulnerability of carotid arteriosclerosis plaque. The values of elasticity of plaque, vessel wall and stiffness of carotid arteriosclerosis plaque in patients with SSS-TOAST 1 style cerebral infarction were lower, and the vulnerability of carotid arteriosclerosis plaque was higher. Real-time tissue elastography had some worth in evaluating the clinical course of patients after cerebral infarction.