Kondo Kosuke, Nemoto Masaaki, Harada Naoyuki, Fukushima Daisuke, Masuda Hiroyuki, Sugo Nobuo
Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Ota-ku, Tokyo, Japan.
Department of Neurosurgery (Omori), School of Medicine, Faculty of Medicine, Toho University, Ota-ku, Tokyo, Japan.
Ultrasound Med Biol. 2017 Jan;43(1):138-144. doi: 10.1016/j.ultrasmedbio.2016.08.014. Epub 2016 Sep 29.
Using a stiffness meter, we quantitatively measured the stiffness of fresh plaques that had been excised by carotid endarterectomy. The objective of this study was to clarify the correlation between plaque stiffness and pre-operative carotid ultrasonographic findings, and predict the stiffness of plaques before surgery by comparison with the stiffness of common items. The study population comprised 44 patients (44 lesions) who had undergone carotid endarterectomy at our institution between December 2009 and October 2014. The stiffness of excised fresh plaques was measured using a stiffness meter and compared with the pre-operative echographic findings for the plaques and the stiffness of selected foods and common items. The mean stiffness value for all plaques was 4.52 ± 3.30 MPa (mean ± standard deviation). The plaques exhibiting calcification were significantly harder (p = 0.001). On classification of lesions on the basis of echographic findings, plaque hardness was in the order low-echoic (15 lesions) < iso-echoic (20 lesions) < high-echoic (9 lesions) (p = 0.02). The stiffness of the low-echoic group was equivalent to that of tofu or sliced cheese, whereas the plaques in the iso- and high-echoic groups exhibited stiffness similar to that of ham and a plastic eraser, respectively. A significant correlation was observed between the quantitative stiffness values of carotid plaques and their brightness on carotid ultrasonography. Using these data, operators might be able to predict plaque stiffness from pre-operative echographic findings. In addition, it might be useful for operators to compare such quantitative stiffness measurements with stiffness data for foods and common items to gain an understanding of the state of the target plaque before treatment.
我们使用硬度计对通过颈动脉内膜切除术切除的新鲜斑块的硬度进行了定量测量。本研究的目的是阐明斑块硬度与术前颈动脉超声检查结果之间的相关性，并通过与常见物品的硬度进行比较来预测手术前斑块的硬度。研究对象包括2009年12月至2014年10月期间在我院接受颈动脉内膜切除术的44例患者（44个病变）。使用硬度计测量切除的新鲜斑块的硬度，并将其与斑块的术前超声检查结果以及所选食物和常见物品的硬度进行比较。所有斑块的平均硬度值为4.52±3.30兆帕（平均值±标准差）。出现钙化的斑块明显更硬（p = 0.001）。根据超声检查结果对病变进行分类，斑块硬度顺序为低回声（15个病变）<等回声（20个病变）<高回声（9个病变）（p = 0.02）。低回声组的硬度与豆腐或切片奶酪相当，而异回声组和高回声组的斑块硬度分别与火腿和塑料橡皮擦相似。颈动脉斑块的定量硬度值与其在颈动脉超声检查中的亮度之间存在显著相关性。利用这些数据，操作人员或许能够根据术前超声检查结果预测斑块硬度。此外，操作人员将此类定量硬度测量结果与食物和常见物品的硬度数据进行比较，可能有助于了解治疗前目标斑块的状态。
