速度向量成像技术评价初诊2型糖尿病患者颈总动脉弹性的研究

目的:探讨速度向量成像(velocity vector imaging,VVI)技术评价初诊2型糖尿病患者颈总动脉(common carotid artery,CCA)弹性的应用价值。方法:选取60例初诊2型糖尿病患者,将其分为内中膜厚度(intima-media thickness,IMT)增加组(T2DM-1组)30例和IMT正常组(T2DM-2组)30例;另选取健康对照组30例。常规二维超声观测糖尿病患者与健康对照组的CCA内径、IMT及斑块情况;采用VVI技术对受检者行颈动脉超声检查,测量并记录右侧CCA管壁短轴方向二维图像前壁、前内侧壁、后内侧壁、后壁、后外侧壁、前外侧壁6个节段的径向最大速度(Vs)、切向最大应变(Smax)及切向最大应变率(SRmax),对各组相关参数进行统计学分析。结果:T2DM-1组IMT厚度显著高于T2DM-2组和对照组(P0.05);T2DM-2组IMT厚度与对照组差异无统计学意义(P0.05);T2DM-1组、T2DM-2组及对照组CCA内径测值差异无统计学意义(P0.05)。T2DM-1组患者CCA 6个节段的Vs、Smax和SRmax显著低于T2DM-2组和对照组(P0.05);T2DM-2组患者CCA 6个节段的Vs、Smax和SRmax显著低于对照组(P0.05)。结论:初诊2型糖尿病患者CCA二维形态未改变以前CCA弹性已经降低,VVI技术可用于评价CCA的弹性状态,能够早期发现初诊T2DM患者的CCA弹性降低。

Research of carotid arterial elasticity in patients with newly diagnosed （type 2） diabetic mellitus by using velocity vector imaging technique

Objective：To investigate the application value of velocity vector imaging （VVI） in assessing the elastic change of common carotid artery in patients with newly diabetes .Methods ：All subjects were divided into T2DM-1 group of 30 patients with thicker IMT ,T2DM-2 group of 30 patients with normal IMT and the normal control group of 30 cases .Two-dimensional dynamic images of the common carotid artery were obtained .The internal diameter ,IMT and carotid atherosclerotic plaque dur-ing its expansion were measured .Then the peak systolic velocity （Vs） ,strain（Smax） and strain rate（SRmax） of the six seg-ments of the common carotid artery wall（anterior wall ,posterior wall ,anterolateral wall ,anterointernal wall ,posterolateral wall and posterointernal wall） were analyzed quantitatively and compared mutually by VVI technique .Results：IMT of T2DM-1 group was significantly higher（P〈0 .05） than that of T2DM-2 group and control group .There was no statistically significant difference between IMT of T2DM-2 group and control group（P〉 0 .05） .There was no statistically significant difference be-tween the internal diameter of T2DM-2 group and control group（P〉0 .05） .The Vs ,Smax and SRmax of T2DM-1 group was lower significantly（P〈0 .05） than that of T2DM-2 group and control group .The Vs ,Smax and SRmax of T2DM-2 group was lower significantly（P〈0 .05） than that of control group .Conclusions ：The CCA elasticity of patients with newly diagnosed dia-betic mellitus decreases before the morphological indicators change .VVI technique is an effective method of quantitatively asses-sing the carotid arterial elasticity .