速度向量成像技术对2型糖尿病患者足背动脉管壁运动的初步评价

目的应用速度向量成像技术（VVI）探讨2型糖尿病（T2DM）患者足背动脉的管壁长轴方向运动速度、应变及应变率的特点。方法使用西门子公司ACUSON Sequoia 512彩色多普勒超声诊断系统,结合同步心电图描记,声学采集条件下分别获取2型糖尿病足背动脉无形态学改变患者20例（T2DM1组）、糖尿病足背动脉有形态学改变患者26例（T2DM2组）和20例无糖尿病健康人（正常对照组）足背动脉的长轴二维图像,并进行动态存储。测量足背动脉平均内中膜厚度（IMT）,收缩末内径（Ds）,收缩期峰值流速（PSV）;并运用VVI软件进行脱机分析,测量足背动脉管壁长轴方向上的最大纵向运动速度（Vmax）、最大应变（Smax）及最大应变率（SRmax）,并进行比较。结果T2DM1组患者足背动脉IMT、Ds和PSV测值与正常人相比差异均无显著性意义（P〉0.05）,而Vmax、Smax、SRmax测值与正常人相比显著减低（P〈0.05或0.01）。T2DM2组患者足背动脉IMT、Ds、PSV测值和Vmax、Smax、SRmax测值与T2DM1组及正常对照组各测值相比差异均有显著性意义（P〈0.05或0.01）。结论VVI技术可用于T2DM足背动脉病变的分析,尤其对于临床未发现血管病变的糖尿病患者的内皮功能障碍可较早地进行检测。

Preliminary assessment of dorsalis pedis arterial wall motion in patientswith type 2 diabetes mellitus by velocity vector imaging

Objective To study the velocity, strain and strain rate of the dorsalis pedis artery in patients with type 2 diabetes mellitus by velocity vector imaging(VVI). Methods The vascular inner diameter (Ds), intima-media thickness (IMT), peak systolic velocity (PSV), vascular wall's maximum velocity (V_max), maximum strain (S_max) and maximum strain rate (SR_max) of dorsalis pedis artery in 20 type 2 diabetes mellitus without dorsalis pedis arterial modality alteration (T2DM1 group), 26 type 2 diabetes mellitus with dorsalis pedis arterial modality alteration (T2DM2 group) and the 20 normal controls (NC group) were acoustically acquired with VVI. Results The Ds, IMT, PSV had no significant differences (P>0.05), but V_max, S_max, SR_max had significant differences between T2DM1 group and NC group (P<0.05 or 0.01). The Ds, IMT, PSV, V_max, S_max, SR_max had significant differences between T2DM2 group and T2DM1 group, NC group (P<0.05 or 0.01). Conclusion VVI is an effective technique for evaluating the dorsalis pedis arterial pathological changes in patients with type 2 diabetes mellitus, especially in the stage of endodermis malfunction before dorsalis pedis arterial modality alteration had developed.