| 摘要: |
| 目的：应用VTIQ技术评价颈动脉斑块软硬度诊断脑梗死的可行性、稳定性及预测价值，探讨高频超声与VTIQ（virtual touch tissue imaging quantification，VTIQ）技术联合预判脑梗死的临床价值。方法：收集60例脑梗死患者和40例非脑梗死患者，根据斑块总风险评分标准筛选出代表性斑块行高频超声和VTIQ检查。记录斑块回声类型（patch echo type，PEH）、狭窄率（stenosis rate，SR）和剪切波速度（shear wave velocity，SWV），比较两组患者的PET构成比、SR及SWV。Bland-Altman检验观察者间一致性。ROC曲线分析三者独立预测脑梗死的临床效能及最佳诊断界值，Logistic回归结合ROC曲线分析多参数联合预测脑梗死的临床价值。结果：两组患者PET构成比及SR的比较均有统计学差异（P=0.000）。脑梗死组SWV显著低于非脑梗死组（P=0.004）。PET、SR、SWV诊断脑梗死的曲线下面积（area under cueve，AUC）分别为0.291、0.722、0.664。SWV观察者间一致性良好。以SWV≤3.435m∕s为界值预测脑梗死的敏感性、特异性、准确性分别为60%、62.5%、70.5%。PET与SR联合预测脑梗死的AUC为0.806；The AUC of cerebral infarction predicted by PET and SR was 0.806. PET、SR和SWV三者联合预测脑梗死的AUC提升到0.945，敏感性、特异性、准确性分别提高到91.67%、82.5%、87%。结论：VTIQ技术评价颈动脉斑块软硬度诊断脑梗死具有可行性和可重复性，颈动脉狭窄率仍然是脑梗死预测的金指标，VTIQ与高频超声联合应用可以提升脑梗死的诊断价值。 |
| 关键词: 超声 弹性 颈动脉 斑块 脑梗死 |
| DOI： |
| 投稿时间：2018-06-20修订日期：2018-07-06 |
| 基金项目: |
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| Evaluation of the relationship between carotid plaque and cerebral infarction by high frequency ultrasound combined with VTIQ |
| hongwei |
| () |
| Abstract: |
| Objective: To evaluate the feasibility, stability and predictive value of the diagnosis of cerebral infarction by using VTIQ. To explore the clinical value of high frequency ultrasound combined with virtual touch tissue imaging quantification (VTIQ) in predicting cerebral infarction. Methods：60 cases of cerebral infarction and 40 cases of non-cerebral infarction were collected。The representative plaques were selected for high-frequency ultrasound and VTIQ examination according to the plaque total risk score standard. Patch echo type (PEH), stenosis rate (SR) and shear wave velocity (SWV) were recorded to compare the PET composition ratio, SR and SWV of the two groups of patients. Bland-Altman tested the consistency between observers. ROC curve analysis of PET, SR and SWV independently predicted the clinical efficacy and optimal diagnostic threshold of cerebral infarction. Logistic regression combined with ROC curve was used to analyze the clinical value of multiple parameters combined to predict cerebral infarction. Results: There were statistically significant differences in PET composition ratio and SR between the two groups (P=0.000). SWV in cerebral infarction group was significantly lower than that in non-cerebral infarction group (P=0.004). PET, SR and SWV were respectively 0.291, 0.722 and 0.664 in the diagnosis of cerebral infarction under cueve (AUC). The SWV value has good observer consistency. The sensitivity, specificity and accuracy of predicting cerebral infarction were 60%, 62.5% and 70.5%, respectively, using SWV less than or equal to 3.435m/s as the boundary value. The AUC of PET, SR and SWV combined to predict cerebral infarction increased to 0.945, and the sensitivity, specificity and accuracy increased to 91.67%, 82.5% and 87%, respectively. Conclusion: It is feasible and repeatable to evaluate the hardness of carotid artery plaque in the diagnosis of cerebral infarction by VTIQ. Carotid stenosis rate is still the gold index of cerebral infarction prediction. Combined application of VTIQ and high-frequency ultrasound can improve the diagnostic value of cerebral infarction. |
| Key words: Ultrasound Elasticity Carotid artery Plaque Cerebral infarction |
