实时三维超声用于颈动脉粥样斑块检测和体积定量的可行性研究

目的探讨实时三维超声技术(RT-3DU)对于颈动脉粥样硬化(AS)斑块检测和体积定量的可行性。方法自29例患者中分别应用外周血管探头和实时三维超声探头扫查颈动脉,共检测到35个AS斑块,分别在二维(2D)和RT-3DU图像中判定斑块的类型;并将获取的全容积数据转入TomTec图像工作站由两名超声医师双盲、随机的在8切面模式下测量体积,其中一位医师在1个月后再次进行体积定量。结果应用RT-3DU可获取满意的颈动脉AS斑块图像,RT-3DU和2D技术对斑块类型判定的一致率为89%,Kappa值=0.83;TomTec工作站可对斑块进行体积定量,35个斑块平均体积为(233±206)mm3,观察者间和观察者内部测量值的变异均无统计学意义。结论RT-3DU可用于颈动脉AS斑块的检测,尤其是空间几何形状的显示;斑块体积定量在观察者间和观察者内部均有较高的可重复性。

The feasibility study on carotid artery atherosclerotic plaques scanning and volumetric quantification with real-time three-dimensional ultrasonography

Objective To validate the feasibility of carotid artery atherosclerotic plaques scanning and volumetric quantification with real-time three-dimensional ultrasonography (RT-3DU). Methods Thirty-five carotid artery atherosclerotic plaques in 29 outpatients were detected with traditional two-dimensional (2D) ultrasonography and RT-3DU in sequence. The plaque types were categorized as lipid, fibrous and calcified based on echo intensity of the plaques, which were determined by two ultrasonographers under 2D and RT-3DU modes respectively, according to the blind protocol. The full volume datasets acquired via RT-3DU were transferred into TomTec 4D CardioView workstation for volume quantification. The volume estimates were obtained by two ultrasonographers according to the same blind protocol mentioned above. One of the two observers repeated the same volume quantification procedure one month later. Results Satisfactory carotid artery images could be obtained with RT-3DU. The agreement of plaque echo intensity between 2D and RT-3DU was more than 0.83. With TomTec workstation, the plaque volumes were quantified, and no significant difference was found within inter-and intra-observer. Conclusion RT-3DU can be used in carotid plaque scanning, especially on spatial geometric shape delineation. With TomTec workstation, plaque volume can be quantified highly reproducibly.