Medical Ultrasound Imaging Centre (MUSIC), Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Medical Ultrasound Imaging Centre (MUSIC), Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Physics of Fluid Group, MESA+ Institute for Nanotechnology, and MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
Ultrasound Med Biol. 2020 Sep;46(9):2145-2163. doi: 10.1016/j.ultrasmedbio.2020.05.013. Epub 2020 Jul 1.
Ischemic stroke is a leading cause of death and disability worldwide, so adequate prevention strategies are crucial. However, current stroke risk stratification is based on epidemiologic studies and is still suboptimal for individual patients. The aim of this systematic review was to provide a literature overview on the feasibility and diagnostic value of vascular shear wave elastography (SWE) using ultrasound (US) in (mimicked) human and non-human arteries affected by different stages of atherosclerotic diseases or diseases related to atherosclerosis. An online search was conducted on Pubmed, Embase, Web of Science and IEEE databases to identify studies using US SWE for the assessment of vascular elasticity. A quality assessment was performed using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) checklist, and relevant data were extracted. A total of 19 studies were included: 10 with human patients and 9 with non-human subjects (i.e., [excised] animal arteries and polyvinyl alcohol phantoms). All studies revealed the feasibility of using US SWE to assess individually stiffness of the arterial wall and plaques. Quantitative elasticity values were highly variable between studies. However, within studies, SWE could detect statistically significant elasticity differences in patient/subject characteristics and could distinguish different plaque types with good reproducibility. US SWE, with its unique ability to assess the elasticity of the vessel wall and plaque throughout the cardiac cycle, might be a good candidate to improve stroke risk stratification. However, more clinical studies have to be performed to assess this technique's exact clinical value.
缺血性脑卒中是全球范围内主要的致死和致残原因，因此充分的预防策略至关重要。然而，目前的脑卒中风险分层是基于流行病学研究的，对于个体患者来说仍然不够理想。本系统评价的目的是提供一篇文献综述，概述使用超声（US）技术的血管剪切波弹性成像（SWE）在（模拟）受不同阶段动脉粥样硬化疾病或与动脉粥样硬化相关疾病影响的人类和非人类动脉中的可行性和诊断价值。我们在 Pubmed、Embase、Web of Science 和 IEEE 数据库上进行了在线检索，以确定使用 US SWE 评估血管弹性的研究。使用诊断准确性研究的质量评估 2（QUADAS-2）清单进行了质量评估，并提取了相关数据。共纳入 19 项研究：10 项为人类患者，9 项为非人类受试者（即，[切除的]动物动脉和聚乙烯醇体模）。所有研究均表明使用 US SWE 评估动脉壁和斑块个体僵硬的可行性。定量弹性值在研究之间差异很大。然而，在研究内部，SWE 可以检测到患者/受试者特征和不同斑块类型之间具有统计学意义的弹性差异，具有良好的可重复性。US SWE 具有在整个心动周期评估血管壁和斑块弹性的独特能力，可能是改善脑卒中风险分层的良好候选方法。然而，需要开展更多的临床研究来评估该技术的确切临床价值。
