本文選題：超聲造影檢查　切入點(diǎn)：頸動(dòng)脈疾病　出處：《內(nèi)蒙古大學(xué)》2014年碩士論文

【摘要】：目的：應(yīng)用彩色多普勒超聲(colour doppler ultrasonic, CDUS)和超聲造影(Contrast-Enhanced Ultrasound, CEUS)檢測頸動(dòng)脈內(nèi)膜斑塊在腦梗死患者組和非梗死組的聲學(xué)圖像特性和新生血管特點(diǎn)及差異,為闡明頸動(dòng)脈內(nèi)膜斑塊與腦梗死的發(fā)生之間的關(guān)系提供依據(jù),以期為預(yù)警腦卒中提供手段。 方法：1、選擇2012年1月至2013年10月在包鋼醫(yī)院住院的新發(fā)經(jīng)頭顱計(jì)算機(jī)斷層掃描(computed tomography, CT)或磁共振成像(magnetic resonance imaging, MRI)證實(shí)為腦梗死患者56例作為腦梗死組,超聲檢查均有頸動(dòng)脈斑塊形成；選擇同期行頸部血管超聲檢查發(fā)現(xiàn)有頸動(dòng)脈斑塊,其中CT或MRI證實(shí)無腦梗死的患者52例作為對照組。2、應(yīng)用CDUS檢測兩組的頸動(dòng)脈狹窄程度,測量頸動(dòng)脈內(nèi)中膜厚度(intima-media thickness, IMT),觀察斑塊的聲學(xué)特征(大小、形態(tài)、回聲強(qiáng)弱等)。3、應(yīng)用CEUS觀察斑塊的新生血管及造影增強(qiáng)強(qiáng)度等。4、通過聲學(xué)定量分析Acoustic quantification analysis軟件在機(jī)分析,并進(jìn)行組間比較。 結(jié)果：1、CDUS能獲得清晰的頸動(dòng)脈病變聲像圖,依據(jù)回聲將斑塊區(qū)分為軟斑(低回聲)及硬斑(強(qiáng)回聲),測定準(zhǔn)確的頸動(dòng)脈病變檢查指標(biāo)(血管狹窄及IMT程度)。2、CEUS可顯示斑塊的新生血管,測量斑塊的增強(qiáng)情況(造影增強(qiáng)分級及造影增強(qiáng)強(qiáng)度)。3、通過比較分析,腦梗死組的中、重度狹窄率(70%)均高于對照組,有統(tǒng)計(jì)學(xué)意義。4、腦梗死組的IMT增厚發(fā)生率及軟斑(低回聲斑塊)檢出率均高于對照組,差異有統(tǒng)計(jì)學(xué)意義。5、腦梗死組斑塊的造影增強(qiáng)分級及增強(qiáng)強(qiáng)度等指標(biāo)均高于對照組,有統(tǒng)計(jì)學(xué)意義。 結(jié)論：CDUS適用于對高危人群早期、廣泛性的臨床篩查應(yīng)用,CEUS可實(shí)時(shí)觀察頸動(dòng)脈斑塊內(nèi)新生血管情況,評估斑塊的易損性,斑塊的聲學(xué)特點(diǎn)及增強(qiáng)特征與腦梗死關(guān)系密切,可以作為有效監(jiān)測指標(biāo)。
[Abstract]:Objective: to investigate the acoustic and angiogenic characteristics of carotid intima plaques in cerebral infarction patients and non-infarction patients by color Doppler doppler ultrasound (CDUSS) and contrast-enhanced ultrasound (CEUSS).To elucidate the relationship between carotid intimal plaque and cerebral infarction, and to provide a means for early warning of stroke.Methods from January 2012 to October 2013, 56 newly diagnosed patients with cerebral infarction were selected as cerebral infarction group, who were admitted to Baogang Hospital from January 2012 to October 2013 by computed tomography (CTI) or magnetic resonance resonance imaging (MRI).Carotid plaques were detected by ultrasonography, carotid plaques were found in the same period, 52 patients with no cerebral infarction confirmed by CT or MRI were used as control group. The degree of carotid artery stenosis was detected by CDUS.Carotid intima-media thicknesswas measured. The acoustical characteristics (size, morphology, echo intensity, etc.) of plaque were observed. The angiogenesis and enhancement intensity of plaque were observed by CEUS. The results were analyzed by Acoustic quantification analysis software.The comparison between groups was carried out.Results the sonogram of carotid artery lesions could be clearly obtained by CDUS.The plaques were divided into soft (hypoechoic) and hard (hyperechoic) plaques according to the echo. The accurate examination indexes of carotid artery lesions (vascular stenosis and degree of IMT) could be used to display the new vessels of the plaques.The enhancement of plaques (contrast enhancement grade and intensity of contrast enhancement were measured. By comparison and analysis, the moderate and severe stenosis rate of cerebral infarction group was higher than that of control group).The incidence of IMT thickening and the detection rate of soft plaque (hypoechoic plaque) in the cerebral infarction group were higher than those in the control group (P < 0.05). The contrast enhancement grade and intensity of the plaque in the cerebral infarction group were higher than those in the control group.There is statistical significance.Conclusion the use of CEUs is suitable for early clinical screening of high-risk population. CEUs can be used to observe the status of intracarotid plaque neovascularization in real time and to evaluate the vulnerability of plaque. The acoustic characteristics and enhanced features of plaque are closely related to cerebral infarction.It can be used as an effective monitoring indicator.
【學(xué)位授予單位】：內(nèi)蒙古大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.33

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