CAJ | 학술논문

目的：应用速度向量成像（ VVI）技术评价糖尿病患者颈动脉斑块形成后血管管壁运动力学的改变。方法应用速度向量成像技术对糖尿病颈总动脉有斑块者（糖尿病组，30例）及健康查体者（健康对照组，30例）进行分析，比较2组长轴切面管壁的运动矢量图、重建三维参数图，计算其最大切向运动速度（ Vs）、最大切向应变（ Smax ）及最大切向应变率（SRmax）。结果健康对照组长轴切向速度、应变、应变率曲线形态分别趋于一致；糖尿病组颈总动脉斑块处管壁切向速度、应变、应变率时间曲线变化大，峰值不定，变化无规律，部分斑块处管壁各位点达峰时间不同步。糖尿病组颈动脉Vs、Smax、SRmax[（15．22±11．50）×10-2cm/s、（2．66±1．01）％、（0．25±0．24）/s]，明显低于健康对照组[（30．32±10．24）×10-2cm/s、（4．49±1．34）％、（0．62±0．34）/s]（ P ＜0．05）。斑块肩部运动速度最大，纤维帽下方管壁运动速度最小，且上下游肩部管壁的应变、变变率高于纤维帽下方处管壁（ P ＜0．05）。结论糖尿病患者颈动脉粥样硬化斑块部位管壁运动的不同步性，表明VVI可以量化评价已发生血管重构的颈动脉管壁运动及其斑块稳定性。
목적：응용속도향량성상（ VVI）기술평개당뇨병환자경동맥반괴형성후혈관관벽운동역학적개변。방법응용속도향량성상기술대당뇨병경총동맥유반괴자（당뇨병조，30례）급건강사체자（건강대조조，30례）진행분석，비교2조장축절면관벽적운동시량도、중건삼유삼수도，계산기최대절향운동속도（ Vs）、최대절향응변（ Smax ）급최대절향응변솔（SRmax）。결과건강대조조장축절향속도、응변、응변솔곡선형태분별추우일치；당뇨병조경총동맥반괴처관벽절향속도、응변、응변솔시간곡선변화대，봉치불정，변화무규률，부분반괴처관벽각위점체봉시간불동보。당뇨병조경동맥Vs、Smax、SRmax[（15．22±11．50）×10-2cm/s、（2．66±1．01）％、（0．25±0．24）/s]，명현저우건강대조조[（30．32±10．24）×10-2cm/s、（4．49±1．34）％、（0．62±0．34）/s]（ P ＜0．05）。반괴견부운동속도최대，섬유모하방관벽운동속도최소，차상하유견부관벽적응변、변변솔고우섬유모하방처관벽（ P ＜0．05）。결론당뇨병환자경동맥죽양경화반괴부위관벽운동적불동보성，표명VVI가이양화평개이발생혈관중구적경동맥관벽운동급기반괴은정성。
Objective To evaluate changes of vascular wall motion mechanics of diabetic patients with carotid plaques applying the velocity vector imaging ( VVI) .Methods The research applied VVI in diabetes group ( patients with ca-rotid artery plaque, 30 cases) and normal control group (30 cases) to make retrospective analysis, which analyzed the long axis plane wall motion vector graph , reconstructed the parameters of the ion of 3D graph, and computed its maximum tangen-tial velocity (Vs), maximum tangential strain (Smax) and maximum tangential strain rate (SRmax).Vascular walls in upstream and downstream shoulders of the carotid artery plaque and beneath the fibrous cap were taken to measure the maximum tangen -tial velocity (Vs), maximum tangential strain (Smax) and maximum tangential strain rate (SRmax).Results In the diabetes group, the curve of tangential velocity , strain, and strain rate time of wall in carotid artery plaque changed significantly, while the peak changed irregularly , and the Smax of wall sites were not synchronized;the Vs[(15.22 ±11.50) ×102 cm/s], Smax [(12.66 ±1.01)%] and SRmax[(0.25 ±0.24)/s] of carotid artery were significantly lower than the normal control group [(30.32 ±10.24) ×10 -2 cm/s], Smax [(4.49 ±1.34)%] and SRmax [(0.62 ±0.34)/s] ( P <0.05).The velocity of walls in shoulder was the maximum , while the velocity of walls beneath the fibrous cap was the minimum , the strain and strain rate of wall in upstream and downstream shoulders of the carotid artery plaque was significantly higher than the ones beneath fi -brous cap ( P <0.05).Conclusion The wall motion in carotid atherosclerotic plaques is asynchronous , VVI can be applied to evaluate the wall motion of carotid artery of diabetic patients with vascular remodeling and the stability of the plaques .