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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >Quantification and assessment of carotid artery lesions: degree of stenosis and plaque volume.
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Quantification and assessment of carotid artery lesions: degree of stenosis and plaque volume.

机译：量化和评估颈动脉病变：狭窄程度和斑块体积。

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Various methods were developed for the quantification of the degree of stenosis: B-mode imaging, CW Doppler with spectral analysis, PW-duplex, and color-flow imaging. The degree of stenosis can be evaluated using transverse views of the carotid in conventional B-mode imaging. The diameters of the residual lumen (Ds) and the external diameter (De) of the artery at the same level are measured and the degree of stenosis (in area) is calculated. Two different Doppler methods have been designed and validated for the quantification of the stenosis degree. The first one is based on the determination of the maximal velocity inside the stenosis and requires the use of a duplex device. The second one, based on the quantification of the hemodynamic disturbances at the outlet of the stenosis, can be used either with a duplex system or with a continuous-wave Doppler system (pencil probe). The color display mode facilitates the determination of the residual lumen and therefore contributes to making the B-mode methodmore accurate. Moreover, it provides a visualization of the blood flow which avoids most of the misinterpretations of B-mode or Doppler data. Several classification systems based on subjective or semi-quantitative criteria (morphological or hemodynamic) were used to identify different grades of stenosis (< 40%, 40% to 60%, 60% to 90%, etc.) These classifications provide an evaluation of the degree of stenosis accurate enough to discuss the possibility of performing an endarterectomy on a symptomatic patient. When the surgical treatment seems to be inappropriate, the patient is treated medically; the follow-up of the lesion (ie, every 6 months) requires a more precise evaluation of the plaque changes than does stenosis classification. Several parameters have been designed and validated for the quantification of the degree of stenosis by ultrasound. These parameters, whether measured with the B-mode and color image or with the Doppler spectrum, allow quantification of the stenosis degree in percentage of lumen reduction with a precision of approximately +/- 10%. Such a quantitative assessment of carotid lesions for a long period of time may be very helpful in evaluating the beneficial effects of medical treatment or in detecting any significant increase of the stenosis that could lead to surgical treatment. A new method for the plaque volume assessment has been recently validated. The plaque volume index expressed in mm3 is calculated from longitudinal and transversal B mode views of the bifurcation.
机译：已开发出多种方法来量化狭窄程度：B型成像，具有频谱分析的CW多普勒，PW双工和色流成像。狭窄程度可以在常规B型成像中使用颈动脉的横断面进行评估。测量相同水平的残余内腔直径（Ds）和动脉外径（De），并计算狭窄程度（以面积计）。设计和验证了两种不同的多普勒方法来量化狭窄程度。第一个是基于狭窄内部最大速度的确定，并且需要使用双工设备。第二种基于对狭窄出口处血流动力学紊乱的定量分析，可与双工系统或连续波多普勒系统（铅笔探头）一起使用。彩色显示模式有助于确定残留流明，因此有助于使B模式方法更准确。此外，它提供了血流的可视化效果，避免了大多数B模式或多普勒数据的误解。基于主观或半定量标准（形态学或血液动力学）的几种分类系统可用于识别不同等级的狭窄（<40％，40％至60％，60％至90％等）。这些分类可评估狭窄程度足够准确，足以讨论对有症状患​​者进行动脉内膜切除术的可能性。如果外科手术治疗似乎不合适，则对患者进行药物治疗;病变的随访（即每6个月一次）需要比狭窄的分类更准确的评估斑块变化。已经设计和验证了几个参数，用于通过超声量化狭窄程度。这些参数，无论是用B模式和彩色图像还是用多普勒光谱测量，都可以以大约+/- 10％的精度量化狭窄程度，以流明减少的百分比表示。长期对颈动脉病变进行这样的定量评估可能对评估药物治疗的有益效果或检测可能导致外科治疗的狭窄程度的显着提高非常有帮助。最近已验证了一种用于斑块体积评估的新方法。牙斑体积指数以mm3表示，是根据分叉的纵向和横向B模式视图计算得出的。

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