徐秀梅　王蓓　米娜娃儿?吾提库尔　周静　翟虹

[摘要] 目的 应用声触诊组织成像量化技术（VTQ）对人颈动脉硬化斑块进行质地硬度测量，以超声造影作为比较，探讨VTQ检测动脉斑块稳定性的临床价值。方法 方便选取2015年1月—2016年12月该院住院患者80例，应用VTQ技术对常规超声诊断的97个颈动脉斑块进行内部质地的剪切波速度（SWV）测定，然后对97个斑块进行超声造影（2D-CEUS），根据2D-CEUS强化特点，出现明显强化的39个斑块诊断为易损斑块，轻度强化及无强化的58个斑块诊断为稳定斑块，比较易损斑块及稳定斑块的SWV值并做出ROC曲线。结果 ①易损斑块SWV值明显低于稳定斑块，差异有统计学意义（P<0.05 ）；②根据ROC曲线下最大面积0.859时，SWV=2.54 m/s为诊断节点值，VTQ诊断易损斑块的敏感度和特异度分别为72.4%、84.6%。结论 声触诊组织成量化技术可以定量测定动脉斑块的质地，从而预测颈动脉斑块的稳定性。

[关键词] 声触诊组织成像量化技术；超声造影；动脉斑块

[中图分类号] R445 [文献标识码] A [文章编号] 1674-0742（2018）01（c）-0182-03

[Abstract] Objective This paper tries to evaluate the hardness of human atherosclerotic plaque by using acoustic palpation Tissue Imaging Quantitative Technology （VTQ）， and to compare the clinical value of VTQ in detecting arterial plaque stability by contrast-enhanced ultrasound. Methods A total of 80 inpatients from January 2015 to December 2016 in this hospital were conveniently enrolled. The VTQ technique was used to determine the shear wave velocity （SWV） of 97 carotid plaques in routine ultrasound diagnosis. Then 97 plaques were implemented ultrasound imaging （2D-CEUS）. According to 2D-CEUS enhancement features， 39 plaques with obvious enhancement were diagnosed as vulnerable plaque. 58 plaques with mild and no enhancement were diagnosed as stable plaques， which were easier to diagnose SWV values of plaque and plaque stability and make ROC curves. Results ①The SWV of vulnerable plaque was significantly lower than that of stable plaque （P<0.05）；②With the maximum area of 0.859 under ROC curve， SWV=2.54 m/s was the value of diagnostic node， the sensitivity and specificity of vulnerable plaques by VTQ diagnosis were 72.4% and 84.6% respectively. Conclusion The acoustic palpation tissue quantification technique can quantitatively determine the texture of arterial plaque to predict the stability of carotid plaque.

[Key words] Acoustic palpation tissue imaging quantification technique； Contrast-enhanced ultrasound； Arterial plaque

心腦血管疾病死亡率及致残率高，并发症多，是一种严重威胁人类健康的疾病，而动脉易损斑块是引起心脑血管意外的主要原因[1]，该研究方便选取2015年1月—2016年12月间收治的80例患者，采用声触诊组织成像量化技术（VTQ）定量检测斑块的内部质地，旨在寻找一种方便、快捷、无创的手段诊断易损斑块，为临床早期预防及治疗易损斑块提供一定的理论依据。报道如下。

1 资料与方法

1.1 一般资料

方便选取该院高血压科、心内科及脑病科住院患者80例，其中女性25例，男性55例，年龄37～87岁，平均年龄（61.5±9.8）岁。纳入标准：经临床确诊存在颈动脉斑块；排除标准：存在造影剂过敏史。

1.2 仪器与方法

使用SIEMENS ACUSON S2000型彩色多普勒超声诊断仪，Multi-D9L4线阵探头，探头频率……