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基于超声剪切波频散成像探讨颈动脉黏弹性与血流动力学的相关性
罗向红1△,闫敏2△,邵思惠3,张健慧3,杜联芳3,李朝军3*
0
(1. 上海交通大学附属上海市第一人民医院超声心动图室, 上海 200080;
2. 阜阳市肿瘤医院超声科, 阜阳 236000;
3. 上海交通大学附属上海市第一人民医院超声医学科, 上海 200080
共同第一作者
*通信作者)
摘要:
目的 应用超声剪切波频散(USWD)技术检测颈动脉黏弹性,探讨其与血流动力学的相关性。方法 招募既往无心脑血管事件病史志愿者45例,依据年龄中位数分为高年龄组(≥ 50岁,n=23)和低年龄组(<50岁,n=22)。采用USWD技术检测受试者颈总动脉,获取颈总动脉剪切波弹性指标动脉壁剪切波弹性模量(SWER)值和剪切波黏性指标动脉壁剪切波频散(SWDR)值;用多普勒超声获取颈总动脉血流动力学参数[速度时间积分(VTI)、收缩期峰值流速(PSV)、舒张末期流速(EDV)和平均流速(MFV)]。采用Pearson相关分析分析SWER和SWDR与血流动力学参数的关系。结果 与低年龄组比较,高年龄组受试者颈总动脉SWER和SWDR均减小(P均<0.05)。高年龄组受试者颈总动脉VTI、PSV、EDV和MFV均小于低年龄组(P<0.05,P<0.01)。颈总动脉剪切波弹性指标SWER与血流动力学参数VTI、PSV、EDV和MFV呈正相关(r=0.354、0.400、0.467和0.310;P<0.01,P<0.05);剪切波黏性指标SWDR与VTI和PSV呈负相关,而与MFV呈正相关(r=-0.481、-0.522和0.352,P均<0.01)。结论 USWD技术可鉴别颈动脉黏弹性指标的变化,这种变化与血流动力学改变有关。
关键词:  超声检查  剪切波频散  颈动脉  血流动力学  黏弹性
DOI:10.16781/j.0258-879x.2019.11.1197
投稿时间:2019-03-02修订日期:2019-06-23
基金项目:促进市级医院临床技能与临床创新能力三年行动计划(16CR3105B),上海市松江区科技攻关项目(18sjkjgg72,18sjkjgg53),上海交通大学医工交叉研究基金(YG2015MS28),上海市科学技术委员会医学引导类科技项目(16411969300),上海市卫生和计划生育委员会基金(201640043).
Correlation between carotid viscoelasticity and hemodynamics based on ultrasound shear wave dispersion imaging
LUO Xiang-hong1△,YAN Min2△,SHAO Si-hui3,ZHANG Jian-hui3,DU Lian-fang3,LI Zhao-jun3*
(1. Department of Echocardiography, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China;
2. Department of Ultrasound, Fuyang Cancer Hospital, Fuyang 236000, Anhui, China;
3. Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 200080, China
Co-first authors.
* Corresponding author)
Abstract:
Objective To measure the carotid viscoelasticity using ultrasound shear wave dispersion (USWD), and to explore the correlation between the viscoelasticity and hemodynamics. Methods Forty-five volunteers without history of cardiovascular and cerebrovascular events were recruited and divided into elder group (≥ 50 years old, n=23) and younger group (<50 years old, n=22) according to the median age. The common carotid arteries were detected by USWD, and SWER (elastic index) and SWDR (viscous index) were obtained. Hemodynamic parameters, including velocity time integral (VTI), peak systolic velocity (PSV), end-diastolic velocity (EDV), and mean flow velocity (MFV), were measured using Doppler ultrasound. Correlations between SWER, SWDR and hemodynamic parameters were analyzed using Pearson analysis. Results The SWER, SWDR, VTI, PSV, EDV and MFV in the elder group were significantly lower than those in the younger group (P<0.05, P<0.01). The SWER was positively correlated with VTI, PSV, EDV and MFV (r=0.354, 0.400, 0.467 and 0.310;P<0.01, P<0.05). The SWDR was negatively correlated with VTI and PSV (r=-0.481 and -0.522, both P<0.01), but positively correlated with MFV (r=0.352, P<0.01). Conclusion USWD may identify the change of carotid viscoelasticity, and the change of viscoelasticity is related to hemodynamics.
Key words:  uitrasonography  shear wave dispersion  carotid arteries  hemodynamics  viscoelasticity