速度向量成像技术评价冠状动脉粥样硬化性心脏病患者颈总动脉管壁形变特征

目的应用速度向量成像(VVI)技术评价冠状动脉粥样硬化性心脏病患者颈总动脉管壁形变特征。方法选择冠状动脉粥样硬化性心脏病患者(冠状动脉粥样硬化性心脏病组)和健康体检者(健康对照组)各30例。采集并存储颈总动脉长轴及短轴二维动态灰阶图像。应用VVI技术分析2组受检者颈总动脉管壁纵向收缩期峰值应变(LS)、纵向收缩期峰值应变率(LSR)及周向收缩期峰值应变(CS)、周向收缩期峰值应变率(CSR)。将颈总动脉长轴后壁3个感兴趣点LSR的平均值定为平均纵向收缩期峰值应变率(mLSR);将颈总动脉短轴管壁6个节段CSR的平均值定为平均周向收缩期峰值应变率(mCSR)。分析冠状动脉粥样硬化性心脏病组患者的mLSR、mCSR与颈总动脉内中膜厚度(IMT)的相关性。结果健康对照组受检者颈总动脉短轴管壁各节段(分别为:前壁、前外侧壁、后外侧壁、后壁、前内侧壁、后内侧壁,下同)CS分别为(8.77±1.58)%、(8.76±1.46)%、(8.80±1.40)%、(8.43±1.41)%、(8.56±1.39)%、(8.54±1.38)%;冠状动脉粥样硬化性心脏病组患者颈总动脉短轴相应管壁节段CS分别为(4.68±1.02)%、(5.23±1.13)%、(4.79±0.99)%、(5.14±1.01)%、(5.08±1.00)%、(4.99±1.03)%,2组受检者颈总动脉短轴管壁相应节段CS比较,差异均有统计学意义(t=10.68、5.23、7.54、6.53、6.38、8.54,P均<0.01)。健康对照组受检者颈总动脉短轴管壁各节段CSR分别为(0.55±0.11)s-1、(0.54±0.11)s-1、(0.53±0.10)s-1、(0.46±0.08)s-1、(0.49±0.09)s-1、(0.51±0.13)s-1;冠状动脉粥样硬化性心脏病组患者颈总动脉短相应管壁节段CSR分别为(0.33±0.14)s-1、(0.32±0.11)s-1、(0.31±0.10)s-1、(0.29±0.09)s-1、(0.29±0.07)s-1、(0.30±0.08)s-1,2组受检者颈总动脉短轴管壁相应节段CSR比较,差异亦均有统计学意义(t=8.03、8.26、8.31、9.23、10.11、7.58,P均<0.01)。健康对照组受检者颈总动脉后壁3个感兴趣点(近心点、中点、远心点,下同)LSR分别为(0.48±0.11)s-1、(0.51±0.09)s-1、(0.53±0.13)s-1,冠状动脉粥样硬化性心脏病组患者颈总动脉后壁相应各点LSR分别为(0.24±0.07)s-1、(0.21±0.09)s-1、(0.23±0.10)s-1,2组受检者颈总动脉后壁相应各点LSR比较,差异均有统计学意义(t=11.12、13.69、15.33,P均<0.01);健康对照组受检者颈总动脉后壁各感兴趣点LS分别为(4.82±1.19)%、(4.68±1.54)%、(4.76±1.33)%,冠状动脉粥样硬化性心脏病组患者颈总动脉后壁相应各感兴趣点LS分别为(4.36±1.79)%、(4.23±1.43)%、(4.48±1.55)%,2组受检者颈总动脉后壁相应各感兴趣点LS比较,差异均无统计学意义(t=1.43、2.25、3.11,P均>0.01)。冠状动脉粥样硬化性心脏病组患者mCSR及mLSR与颈总动脉IMT均呈显著负相关,相关系数分别为-0.864和-0.853(P<0.0001)。结论 VVI技术可以评价冠状动脉粥样硬化性心脏病患者颈总动脉管壁形变特征。冠状动脉粥样硬化性心脏病患者颈总动脉管壁形变能力减弱,其减弱的程度与颈总动脉IMT相关。

Deformability assessment of common carotid wall in patients with coronary artery disease using velocity vector imaging techinique

Objective To assess the deformation features of common carotid arterial wall in patients with coronary artery disease（CAD）using velocity vector imaging（VVI）technique.Methods Thirty patients with coronary artery disease（coronary artery disease group）and 30 normal controls（health control group）were enrolled in the study.The two-dimensional grayscale images of common carotid were obtained and dynamically stored in both long and short axis views.The peak systolic longitudinal and circumferential strain and strain rate values were analyzed using VVI technique.The average of peak systolic longitudinal strain rate of three different points along the posterior wall of common carotid wall in the long axis view was defined as mean longitudinal strain rate（mLSR）and the average of peak systolic circumferential strain rate of six segments around common carotid wall in the short axis view was defined as mean circumferential strain rate（mCSR）.Results The segmental peak systolic circumferential strain（CS）of common carotid wall in short axis view in health control group were（8.77±1.58）%,（8.76±1.46）%,（8.80±1.40）%,（8.43±1.41）%,（8.56±1.39）% and（8.54±1.38）%,while the matching segmental measurements in coronary artery disease group were（4.68±1.02）%,（5.23±1.13）%,（4.79±0.99）%,（5.14±1.01）%,（5.08±1.00）% and（4.99±1.03）%.There were significant difference between the two groups in each matching segment（t=10.68,5.23,7.54,6.53,6.38 and 8.54,all P〈0.01）.The segmental segmental peak systolic circumferential strain rate（CSR）of common carotid wall in short axis view in health control group were（0.55±0.11）s-1,（0.54±0.11）s-1,（0.53±0.10）s-1,（0.46±0.08）s-1,（0.49±0.09）s-1 and（0.51±0.13）s-1,while the matching segmental measurements in coronary artery disease group were（0.33±0.14）s-1,（0.32±0.11）s-1,（0.31±0.10）s-1,（0.29±0.09）s-1,（0.29±0.07）s-1 and（0.30±0.08）s-1.There also showed significant difference between the two groups in each matching segment（t=8.03,8.26,8.31,9.23,10.11 and 7.58,all P〈0.01）.The segmental peak systolic longitudinal strain rate（LSR）of common carotid wall in long axis view in health control group were（0.48±0.11）s-1,（0.51±0.09）s-1 and（0.53±0.13）s-1,while the matching segmental measurements in coronary artery disease group were（0.24±0.07）s-1,（0.21±0.09）s-1 and（0.23±0.10）s-1.There were also significant difference between the two groups in each matching point（t=11.12,13.69 and 15.33,all P〈0.01）.The segmental peak systolic longitudinal strain（LS）of common carotid wall in long axis view in health control group were（4.82±1.19）%,（4.68±1.54）% and（4.76±1.33）%,and the matching point measurements in coronary artery disease group were（4.36±1.79）%,（4.23±1.43）% and（4.48±1.55）%.There showed no significant difference between the two groups in each matching point（t=1.43,2.25 and 3.11,all P〈0.01）.Both mean CSR（mCSR）and mean LSR（mLSR）shown significant negative correlation with IMT in CAD group（the correlation coefficient were-0.864 and-0.853,respectively,both P〈0.0001）.Conclusions VVI technique can be used to analyze the deformation features of common carotid artery in patients with coronary artery disease.The deformability of common carotid wall in patients with coronary artery disease is depressed and the depressed degree correlated with intimal medial thickness.