脑梗死患者颈动脉粥样硬化斑块应变成像研究

目的 探讨斑点追踪应变成像（X-strain imaging，XS）评价脑梗死患者颈动脉斑块运动特点的价值。 方法 选择2015年3月-2016年2月常规超声检查患有颈动脉粥样硬化斑块形成的脑梗死患者26例 为脑梗死组，同时选取24例非脑梗死颈动脉粥样硬化斑块患者为对照组。两组均行常规超声和XS 检查，比较两组间颈动脉斑块不同位置（近心端肩峰、顶部及远心端肩峰）应变成像及运动特点。 结果 常规超声显示脑梗死组颈动脉粥样硬化斑块大小、不同回声斑块数目与对照组差异无统计 学意义。XS检查显示，与对照组相比，脑梗死组颈动脉斑块近心端肩峰、顶部及远心端肩峰的轴向 和横向运动速度、轴向和横向位移、应变均较大，两组差异有统计学意义。脑梗死组患者斑块近心 端肩峰运动较远心端肩峰明显，其横向移动速度（ 0.25±0.07）cm/s vs（0.15±0.05）cm/s]和位移 （ 0.28±0.10）mm vs（0.17±0.05）mm]均高，差异有统计学意义；顶部应变（ 2.75±1.01）%]较近心端 肩峰（ 4.43±1.08）%]和远心端肩峰（ 4.23±1.24）%]均低，差异有统计学意义。 结论 脑梗死患者颈动脉粥样硬化斑块应变及运动较明显，斑块易损性高。

X-strain Imaging Characteristics of Carotid Atherosclerostic Plaques in Patients with Cerebral Infarction

Objective To investigate the value of X-strain imaging (XS) in evaluating carotid plaque motility
in patients with cerebral infarction.
Methods 26 cerebral infarction patients with carotid atherosclerotic plaques identified by carotid
ultrasound from March 2015 to February 2016 were enrolled in cerebral infarction group, and 24
non-stroke patients with carotid atherosclerotic plaques as the control group. Both groups were all
examined by X-strain imaging and carotid ultrasound. The strain and movement characteristics of
carotid plaques in different positions were compared between the two groups.
Results There was no significant difference in carotid plaque size between the two groups by
conventional ultrasound. XS results showed that the strain and movement of the plaques between
the two groups had significant difference. The movement of plaque in proximal shoulder was more
obvious than that in distal shoulder in cerebral infarction group, the transverse movement speed
(0.25±0.07) cm/s vs (0.15±0.05) cm/s] and displacement (0.28±0.10) mm vs (0.17±0.05) mm] in
proximal and distal subgroups also had significant difference. The strain in the top (2.75±1.01)%]
was lower than that in proximal shoulder (4.43±1.08)%] and distal shoulder (4.23±1.24)%], the
difference was statistically significant.
Conclusions The strain and movement of carotid plaques in patients with cerebral infarction are
more obvious, and the plaques vulnerability is high.