本文選題：頸動(dòng)脈斑塊　切入點(diǎn)：粥樣硬化　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本研究將傳統(tǒng)超聲測(cè)量頸動(dòng)脈斑塊最厚處管壁厚度、管腔面積、管壁面積、血管總面積并計(jì)算管壁標(biāo)準(zhǔn)化指數(shù)五項(xiàng)指標(biāo),與MR頸動(dòng)脈斑塊成像五項(xiàng)指標(biāo)進(jìn)行對(duì)比研究,以此評(píng)價(jià)MRI與超聲檢測(cè)斑塊負(fù)荷的一致性。方法:選擇經(jīng)超聲和高清MRI檢出并匹配的45個(gè)頸動(dòng)脈斑塊病例21例,男15例,女6例,平均年齡61.3±9.9歲。其中吸煙7例,飲酒11例,高脂血癥10例,高血壓10例,糖尿病8例,合并腦梗死5例。由兩名有經(jīng)驗(yàn)醫(yī)師評(píng)價(jià)圖像的質(zhì)量,觀察斑塊的個(gè)數(shù)及分布(本研究不包含頸外動(dòng)脈斑塊),并分別測(cè)量頸動(dòng)脈斑塊最厚處的最大管壁厚度(Maximal wall thickness,MWT)、管腔面積(Lumen area,LA)、管壁面積(Wall area,WA)、血管總面積(Total vascular area,TVA)、用管壁面積除以血管總面積計(jì)算得出管壁標(biāo)準(zhǔn)化指數(shù)(Normalized wall index,NWI),對(duì)五項(xiàng)形態(tài)學(xué)指標(biāo)進(jìn)行一致性分析。結(jié)果:45個(gè)斑塊的位置分別是:左頸總動(dòng)脈7個(gè),右頸總動(dòng)脈7個(gè),左側(cè)分叉處9個(gè),右側(cè)分叉處10個(gè),左側(cè)頸內(nèi)動(dòng)脈5個(gè),右側(cè)頸內(nèi)動(dòng)脈7個(gè)。斑塊引起的管腔狹窄程度,兩種檢查結(jié)果一致性達(dá)93.3%(42/45)。頸動(dòng)脈斑塊高清MRI所測(cè)得的平掃斑塊厚度2.88 mm、平均管腔面積45.94mm2、平均管壁面積40.5 mm2、平均血管總面積86.66 mm2和平均NWI值0.50。頸動(dòng)脈超聲所測(cè)得的平均斑塊厚度2.56mm、平均管腔面積43.05 mm2、平均管壁面積40.16 mm2、平均血管總面積82.59 mm2和平均NWI值0.50。經(jīng)統(tǒng)計(jì)學(xué)處理,頸動(dòng)脈斑塊高分辨率磁共振與頸動(dòng)脈超聲所測(cè)得的斑塊厚度、管腔面積、管壁面積、血管總面積和NWI值均無(wú)明顯統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論:頸動(dòng)脈高清MR與傳統(tǒng)超聲在測(cè)量斑塊負(fù)荷方面存在良好的一致性,兩種檢查方法均可以對(duì)斑塊負(fù)荷進(jìn)行精確評(píng)價(jià)。
[Abstract]:Objective: To study the traditional ultrasound measurement of carotid plaque thickest wall thickness, lumen area, wall area, total vessel area and calculate the five indexes of normalized wall index, compared with the five indexes of MR of carotid artery plaque imaging, to evaluate the consistency of MRI and ultrasonic detection of plaque load. Methods: 21 cases of 45 cases of carotid artery plaque by ultrasound and HD MRI detection and matching, male 15 cases, female 6 cases, mean age 61.3 + 9.9 years. Among them, 7 cases of smoking and drinking in 11 cases, 10 cases of hyperlipidemia, 10 cases of hypertension, 8 cases of diabetes, 5 cases complicated with cerebral infarction. By two experienced physicians to evaluate the quality of the image, observe the plaque number and distribution (this study does not include the external carotid artery plaque), the maximum wall thickness were measured and the thickness of carotid plaque (Maximal wall, thickness, MWT), lumen area (Lumen area, LA), wall area (Wall area, WA The total vessel area (Total), vascular area, TVA), with the wall area divided by the total vessel area calculated normalized wall index (Normalized wall, index, NWI), consistency analysis of five morphological indexes. Results: the 45 patch position are: the left carotid artery in 7, right the common carotid artery in 7, left at 9, 10 on the right side of the left internal carotid artery bifurcation, 5, 7. Right internal carotid artery stenosis caused by plaque, two examination results consistency reached 93.3% (42/45). Carotid plaque HD MRI measured plain plaque thickness 2.88 mm, average the lumen area is 45.94mm2, average wall area of 40.5 mm2, the average total vessel area of 86.66 mm2 and the average NWI value of the average plaque thickness measured by 2.56mm 0.50., carotid artery ultrasound, the average cross-sectional area of 43.05 mm2, the average wall area of 40.16 mm2, the average total vessel area of 82.59 mm2 and the average NWI value of 0.5 0. after statistical treatment, carotid artery plaque high resolution magnetic resonance imaging and carotid ultrasound measurement of plaque thickness, lumen area, wall area, there were no statistically significant differences in the total vessel area and the value of NWI (P0.05). Conclusion: carotid artery HD MR and traditional ultrasound are in good agreement in the measurement of plaque burden two, examination methods can be accurate assessment of plaque burden.

【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R543.4;R445

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本文編號(hào)：1591615