超声微血管成像技术评估下肢动脉硬化闭塞症支架术后再狭窄
Super Microvascular Imaging Technique in Evaluating Restenosis After Stenting of Arteriosclerosis Obliterans of Lower Extremity
赫兰 1杨少玲 1张颖 2张春爽 2钟晓妍2
作者信息
- 1. 上海市第八人民医院超声医学科,上海 200235
- 2. 大连大学附属新华医院超声医学科,辽宁 大连 116300
- 折叠
摘要
目的 探讨超声微血管成像(SMI)技术在下肢动脉硬化闭塞症(LEASO)支架术后再狭窄评估中的应用价值.资料与方法 回顾性分析大连大学附属新华医院 2017 年 1 月—2019 年 12 月LEASO支架植入术后 25 根血管(20 例患者)的常规血管超声、SMI和数字减影血管造影(DSA)检查结果,并进行一致性检验;以DSA为"金标准",观察SMI对LEASO的诊断价值.结果 再狭窄程度评估:DSA显示闭塞7枚(28.0%),重度狭窄14枚(56.0%),中度狭窄4枚(16.0%);常规血管超声显示闭塞 13 枚(52.0%),重度狭窄 9 枚(36.0%),中度狭窄 3 枚(12.0%);SMI显示闭塞 9 枚(36.0%),重度狭窄 12 枚(48.0%),中度狭窄4枚(16.0%).一致性分析:常规血管超声与DSA一致性强度中等(Kappa=0.558),SMI与DSA一致性强度高(Kappa=0.868),SMI与常规血管超声一致性强度中等(Kappa=0.420),差异均有统计学意义(P<0.01).结论 SMI评估再狭窄程度与DSA的一致性强,且优于常规血管超声,或可成为LEASO支架术后随访、判断支架内再狭窄的一种新方法.
Abstract
Purpose To investigate the application value of super microvascular imaging(SMI)in the evaluation of restenosis after stenting of arteriosclerosis obliterans of lower extremity(LEASO).Materials and Methods The data of conventional ultrasound,SMI and digital subtraction angiography(DSA)of 25 vessels(20 cases)after LEASO stent implantation in lower extremity vessels from January 2017 to December 2019 in Xinhua Hospital Affiliated to Dalian University were retrospectively analyzed.The consistency of three methods was analyzed via Kappa test.Taken results of DSA as the golden standards,the diagnostic efficacy of LEASO with SMI was compared.Results Evaluation of the degree of restenosis of DSA showed that there were 7 vessels with occlusions(28.0%),14 vessels with severe stenosis(56.0%),4 vessels with moderate stenosis(16.0%);conventional vascular ultrasound showed that there were 13 vessels with occlusions(52.0%),9 vessels with severe stenosis(36.0%),3 vessels with moderate stenosis(12.0%);SMI showed that there were 9 vessels with occlusions(36.0%),12 vessels with severe stenosis(48.0%),4 vessels with moderate stenosis(16.0%).The consistency strength between conventional vascular ultrasound and DSA was moderate(Kappa=0.558),that between SMI and DSA was high(Kappa=0.868),and that between SMI and conventional vascular ultrasound was moderate(Kappa=0.420),with statistical significance differences(all P<0.01).Conclusion SMI has strong consistency with DSA in assessing the degree of restenosis and may be better than conventional vascular ultrasound,maybe it can become a new method for follow-up and judgment of in-stent restenosis after LEASO stenting in lower extremity vessels.
关键词
下肢动脉硬化闭塞症/超声检查/血管造影术/超声微血管成像/支架内再狭窄Key words
Arteriosclerosis obliterans of lower extremity/Ultrasonography/Angiography/Super microvascular imaging/In-stent restenosis引用本文复制引用
基金项目
上海市徐汇区智慧医疗专项研究项目(XHZH202108)
上海市卫生健康委-临床研究专项(202340181)
出版年
2024
NETL
NSTL
万方数据