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中华医学超声杂志(电子版) ›› 2016, Vol. 13 ›› Issue (03) : 231 -236. doi: 10.3877/cma.j.issn.1672-6448.2016.03.013

所属专题: 文献

基础研究

超声实时组织弹性技术评估兔颈动脉粥样硬化斑块分型与病理的对照研究
李玲1, 朱建平1,(), 蒋彦彦1, 江丽1, 洪峻峰1   
  1. 1. 350025 福州总医院超声诊断科
  • 收稿日期:2016-01-06 出版日期:2016-03-01
  • 通信作者: 朱建平
  • 基金资助:
    福建省自然科学基金资助项目(2012J01409)

Assessment of the rabbit carotid atherosclerotic plaques using ultrasound real-time tissue elastography technique with pathologic correlation

Ling Li1, Jianping Zhu1,(), Yanyan Jiang1, Li Jiang1, Junfeng Hong1   

  1. 1. Department of Ultrasonic diagnosis, Fuzhou General Hospital, Fuzhou 350025, China
  • Received:2016-01-06 Published:2016-03-01
  • Corresponding author: Jianping Zhu
  • About author:
    Corresponding author: Zhu Jianping, Email:
引用本文:

李玲, 朱建平, 蒋彦彦, 江丽, 洪峻峰. 超声实时组织弹性技术评估兔颈动脉粥样硬化斑块分型与病理的对照研究[J/OL]. 中华医学超声杂志(电子版), 2016, 13(03): 231-236.

Ling Li, Jianping Zhu, Yanyan Jiang, Li Jiang, Junfeng Hong. Assessment of the rabbit carotid atherosclerotic plaques using ultrasound real-time tissue elastography technique with pathologic correlation[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(03): 231-236.

目的

探讨超声实时组织弹性成像(RTE)技术在颈动脉易损斑块检测中的应用价值。

方法

健康雄性大耳白兔15只,体重2~2.5 kg,高脂喂养联合空气干燥术建立兔颈动脉粥样硬化模型(CAS),常规超声将颈动脉斑块回声分为4种类型,RTE技术获得各型斑块的弹性硬度指数和硬度比值Ratio值,并分析斑块常规超声分型与弹性参数、病理分型之间的相关性。

结果

15只实验兔成功建立28条CAS模型,51个斑块中34个纳入实验。斑块4组超声分型与病理类型呈正相关(r=0.602,P<0.01)。弹性硬度指数、硬度比值Ratio值与常规超声斑块分型亦呈正相关(r=0.538,0.563,P值均<0.01)。弹性硬度指数中,Ⅰ型与Ⅱ型、Ⅱ型与Ⅲ型差异无统计学意义,Ⅰ型与Ⅲ型、Ⅰ型与Ⅳ型、Ⅱ型与Ⅳ型、Ⅲ型与Ⅳ型比较,差异具有统计学意义(t=2.25,2.08,2.95,2.57,P值均<0.05)。硬度比值Ratio值中,Ⅰ型与Ⅱ型差异无统计学意义,Ⅰ型与Ⅲ型、Ⅰ型与Ⅳ型、Ⅱ型与Ⅲ型、Ⅱ型与Ⅳ型、Ⅲ型与Ⅳ型比较,差异均有统计学意义(t=2.66,2.91,2.45,2.60,2.12,P值均<0.05)。

结论

RTE技术能够应用弹性参数量化斑块性质,间接反映斑块病理结构,可能为易损斑块的评估提供有用的指标。

Objective

To investigate the application value of ultrasound real-time tissue elastography technology (RTE) in the detection of the vulnerable carotid atherosclerotic plaques.

Methods

The carotid atherosclerosis models (CAS) of rabbits were established by high fat feeding combined with air drying technique treatment in 15 healthy male large-ear rabbits weighting 2-2.5 kg. The plaques were classified into 4 types based on the conventional ultrasound analysis and the elastic hardness index. The hardness ratio of plaque in each type was further analyzed by using RTE technique. Then the correlations between the conventional ultrasound classification and elastic parameter and histological type were analyzed.

Results

28 CAS models were successfully established from the 15 rabbits, among them 34 of the 51 plaques were included in this investigation. A positive correlation (r=0.602, P<0.01) of plaques classified by ultrasound and their pathological types was observed in all the four groups. The positive correlations (r=0.538, 0.563, both P<0.01) between the conventional ultrasound classification and the elastic hardness index and the hardness ratio were also detected. In terms of plaque elastic hardness index, no significant differences between Group Ⅰ and Ⅱand group Ⅱ and Ⅲ were detected. However, there were significant differences in other comparisons: Ⅰ vs Ⅲ, Ⅰ vs Ⅳ, Ⅱ vs Ⅳand Ⅲ vs Ⅳ group (t=2.25, 2.08, 2.95, 2.57, all P<0.05). In comparison of the hardness ratio, no difference was detected between group Ⅰ and group Ⅱ. However, there were significant differences among the other groups: Ⅰ vs Ⅲ, I vs Ⅳ, Ⅱ vs Ⅲ, Ⅱ vs Ⅳand Ⅲ vs Ⅳgroup (t=2.66, 2.91, 2.45, 2.60, 2.12, all P<0.05).

Conclusion

RTE technology can be used to quantify plaque characteristics by using the elastic parameters, which may indirectly reflect the pathological structures of plaques, probably providing a useful index for assessment of vulnerable plaque.

图1~4 兔颈动脉斑块二维超声声像图。图1示均质低回声斑块(Ⅰ型);图2 示不均质低回声斑块(Ⅱ型);图3 示不均质高回声斑块(Ⅲ型);图4 示均质高回声斑块(Ⅳ型)
图5~8 兔颈动脉斑块、参考区的二维超声及弹性超声图。图5示前、后壁Ⅲ型不均质偏强斑块;图6 为后壁斑块二维灰阶及弹性成像图;图7为斑块、参考区弹性指数随时间变化曲线;图8 为斑块、参考区Ratio值随时间变化曲线
表1 兔颈动脉斑块常规超声分型与病理分型的相关性
表2 不同超声分型兔颈动脉斑块硬度指数及硬度比值Ratio值比较(±s
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