刘娟娟+孙健+瞿国萍+罗伟权+纪宗萍+曾福强

[摘要] 目的 应用超声弹性成像检测颈动脉斑块的物理性质，探讨斑块应变率等参数与斑块稳定性的关系，为脑卒中的预防和诊断治疗提供新的影像学参数。方法 研究对象为2013年1月—2014年8月该院收治的50例脑卒中患者，以常规超声检测颈动脉，并对检测结果进行统计分析。 结果 经常规超声检查，共检出低回声斑块29处，混合回声斑块35处，钙化斑块12处；实时超声弹性成像中低回声斑块呈现为黄绿色或者是绿色，混合回声斑块为蓝绿相间、强回声斑块呈完全蓝色；50例患者中，37例患者颈动脉斑块硬度比值不足5.0。低回声斑块组B/A值为（1.75±0.75），混合回声斑块组B/A值为（6.98±1.19），强回声斑块组B/A值为（38.89±3.03），显然，三组斑块B/A值呈现逐渐升高趋势，两两比较差异有统计学意义。 结论 实时超声弹性成像在颈动脉斑块稳定性评估中具有显著地临床价值，值得关注并推广。

[关键词] 脑卒中；实时超声弹性成像；颈动脉斑块；稳定性

[中图分类号] R445.1 [文献标识码] A [文章编号] 1674-0742（2015）02（c）-0001-03

[Abstract] Objective To detect the physical properties of carotid plaque by real-time ultrasound elastography and investigate the relationship of plaque strain rate and other parameters with plaque stability so as to provide new radiographic parameters for the prevention and diagnosis and treatment of stroke. Methods Conventional ultrasound was used to detect the carotid artery in 50 subjects with stroke admitted to the hospital from January 2013 to August 2014. And the result of detection was analyzed statistically. Results A total of 29 low-echo plaques， 35 mixed-echo plaques and 12 calcified plaques were detected by the conventional ultrasound. In the real-time ultrasound elastography， the low-echo plaques are green-yellow or green， mixed-echo plaques are blue and green， and the strong-echo plaques are completely blue. Of the 50 patients， the carotid plaque hardness ratio of 37 cases was lower than 5.0. The B/A value of the low-echo plaque group was （1.75±0.75）， that of the mixed-echo plaque group was （6.98±1.19）， and that of strong-echo plaque group was （38.89±3.03）. Obviously， the B/A value of the three groups showed a trend of rising， and the pairwise comparison had statistical significance. Conclusion The real-time ultrasound elastography has significant clinical value in the assessment of carotid plaque stability， so it is worthy of attention and promotion.

[Key words] Stroke； Real-time ultrasound elastography； Carotid plaque； Stability

该研究中出于对应用超声弹性成像检测颈动脉斑块的物理性质，探讨斑块应变率等参数与斑块稳定性的关系，为脑卒中的预防和诊断治疗提供新的影像学参数的目的，对该院2013年1月—2014年8月收治的50例脑卒中患者的超声弹性成像结果进行了统计分析，现报道如下。

1 资料与方法

1.1 一般资料

研究中资料来源于该院收治的临床确诊脑卒中患者，抽取其中的50例作为研究对象，另抽取同期存在颈动脉斑块但未发生过脑卒中人群50例，脑卒中组包括有男38例，女12例，年龄42～81岁之间，平均（61.5±13.8）岁。……