Objective To explore the application value of the real-time ultrasound elastography in evaluating of carotid atherosclerotic plaque stability. Methods 41 patients of atherosclerosis with 65 common carotid artery plaques were examined with the real-time ultrasound elastography, and the plaque of different two-dimensional gray scale image features and the corresponding elastic scoring and elastic strain ratio were analyzed. Results (1) Two-dimensional gray-scale ultrasound found 65 plaques, including 35 hypoechoic plaques, 3 hybrid echo plaques and 7 hyperechoic plaques. (2) Hypoechoic plaque elasticity scores were mostly 1 points; the hybrid echo plaque ones were mostly 2-3 points; hyperechoic plaque ones were more than 4 points. Three groups had statistically significant differences in plaque elasticity score (P< 0.05). (3) Strain rate of hyperechoic plaque group and hybrid echo plaques group plaque was significantly higher than hypoechoic plaque group, the difference was statistically significant (P<0.05) ; Strain rate of hyperechoic plaque group were significantly higher than hypoechoic plaque group, the difference was statistically significant (P <0.05). (4) There was a good correlation between two-dimensional ultrasound plaque characteristics and the elasticity score and elastic strain ratio. Conclusion Real-time ultrasound elastography by visual score and strain rate ratio (B/A ratio, the hardness ratio) can reflect the acoustic characteristics of the plaque, and provide more information for the assessment of atherosclerotic plaque stability .%目的 探讨实时超声弹性成像技术评估动脉粥样硬化症患者颈总动脉粥样斑块稳定性的应用价值.方法 应用实时超声弹性成像技术对41例动脉粥样硬化症患者的65处颈总动脉斑块进行检测,将上述斑块不同的二维灰阶图像特征与其对应的弹性评分及弹性应变率比值方面的资料做对照分析研究.结果 (1)二维灰阶超声共发现斑块65个,其中低回声斑35个,混合回声斑23个,强回声斑7个； (2)低回声斑弹性评分多为1分；混合回声斑评分多为为2～3分；强回声斑评分多为4分.3组斑块的弹性评分的差异均有统计学意义(P＜0.05)； (3)强回声斑块组及混合回声斑块组的应变率比值明显高于低回声斑块组,差异有统计学意义(P＜0.05),强回声斑块组应变率比值明显高于混合回声斑块组,差异有统计学意义(P＜0.05)； (4)斑块的二维超声特征与弹性评分及弹性应变比值间有较好的相关性.结论 实时超声弹性成像技术可通过目测评分法及应变率比值(B/A比,即硬度比值)反映斑块的声学特征,可为动脉粥样硬化斑块稳定性的评估提供更多的信息.
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