Lou Zhe, Yang Jun, Tang Li, Jin Youhe, Zhang Jinsong, Liu Chao, Li Qiaobei
Department of Cardiovascular Ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China.
Department of Abdominal Ultrasonic Diagnosis, the First Affiliated Hospital of China Medical University, Shenyang, China.
J Ultrasound Med. 2017 Jun;36(6):1213-1223. doi: 10.7863/ultra.16.04073. Epub 2017 Feb 20.
Shear wave elastography (SWE) was performed to evaluate the Young's modulus of carotid plaques in patients presenting with cerebrovascular incidents, to estimate the clinical value and feasibility of this approach.
Sixty-one patients (mean age, 65 years; 45 men) underwent common duplex ultrasonic examination and SWE evaluation. The patients were divided into the symptomatic and asymptomatic groups based on the presence of unilateral focal neurological symptoms. Elasticity and echogenicity of the carotid plaque was assessed by Young's modulus and Gray-Weale classification, respectively.
A total of 271 carotid plaques were assessed through duplex ultrasonic examination and SWE imaging. The Bland-Altman test revealed a perfect reproducibility of Young's modulus measurement using SWE. The interframe coefficient of variation was 16% within the 271 plaques. In the 61 representative plaques, significant correlations were found between Gray-Weale classification and mean Young's modulus (r = 0.728, P < .01) when the confounding factors were controlled. The mean Young's modulus of representative plaques in symptomatic group was lower than those in asymptomatic groups (mean Young's modulus: 81 kPa versus 115 kPa; P < .01). Logistic regression combined with receiver operating characteristic analysis suggested increased sensitivity and specificity for the identification of symptomatic carotid plaques when the mean Young's modulus was combined with stenosis rate.
Shear wave elastography can evaluate the Young's modulus of carotid plaque stably, and could serve as an additional method for the detection of symptomatic carotid plaques, which, in combination with common ultrasound, can promote the efficiency of differentiating symptomatic carotid plaques.
采用剪切波弹性成像（SWE）评估脑血管事件患者颈动脉斑块的杨氏模量，以评估该方法的临床价值和可行性。
61例患者（平均年龄65岁；45例男性）接受了常规双功超声检查和SWE评估。根据是否存在单侧局灶性神经症状将患者分为有症状组和无症状组。分别通过杨氏模量和Gray-Weale分类评估颈动脉斑块的弹性和回声性。
通过双功超声检查和SWE成像共评估了271个颈动脉斑块。Bland-Altman检验显示使用SWE测量杨氏模量具有良好的可重复性。在271个斑块中，帧间变异系数为16%。在61个代表性斑块中，控制混杂因素后，Gray-Weale分类与平均杨氏模量之间存在显著相关性（r = 0.728，P < 0.01）。有症状组代表性斑块的平均杨氏模量低于无症状组（平均杨氏模量：81 kPa对115 kPa；P < 0.01）。逻辑回归结合受试者工作特征分析表明，当平均杨氏模量与狭窄率相结合时，识别有症状颈动脉斑块的敏感性和特异性增加。
剪切波弹性成像可以稳定地评估颈动脉斑块的杨氏模量，并可作为检测有症状颈动脉斑块的辅助方法，与普通超声相结合可提高鉴别有症状颈动脉斑块的效率。
