弹性成像应变率比值法评价血栓硬度与短期溶栓效果的相关性研究-影像医学与核医学专业论文.docxVIP

摘要 摘要 万方数据 万方数据 摘 要 目的：应用超声弹性成像技术评价下肢深静脉血栓硬度，探讨血栓硬度与 短期溶栓效果间的相关性及应变率比值法在预测溶栓效果中的应用价值。 方法： 对 63 例 急 性 下 肢 深 静 脉 血栓 患 者 在 治 疗 前 行 超 声 弹 性 成 像 （Ultrasound Elastography，UE）检查，测定血栓与周围软组织间的弹性应变率 比值（strain ratios，SRs）；经过 10 天的抗凝、溶栓治疗，根据治疗效果不同， 将其分为治愈组、治疗有效组、治疗无效组，比较各组间血栓 SRs 的差异；将 治愈及治疗有效者归为总有效组，将血栓 SRs 与治疗是否有效对照，构建受试 者工作特征曲线（ROC）并确定溶栓是否有效的 SRs 临界值。 结果：（1）血栓硬度与溶栓效果具有一定相关性。治愈组的血栓及治疗有 效组的血栓硬度明显小于治疗无效组。治愈组与治疗有效组血栓间硬度无明显 差异。 （2）血栓SRs可以预测溶栓治疗效果。以SRs＜1.36预测治疗有效，以 SRs≥1.36预测治疗无效其敏感性、特异性为、准确性分别为88.9%、94.4%、93.7%。 结论：血栓硬度与溶栓效果具有一定相关性，超声弹性成像应变率比值法 可以用来评价血栓硬度，并预测治疗效果，可指导临床医生把握正确的溶栓时 机，避免不必要的溶栓治疗。 关键词：超声弹性成像；弹性应变率比值；血栓；硬度；溶栓效果 II Abs Abstract ABSTRACT Objective: To evaluate the hardness of lower extremity deep vein thrombosis by ultrasound elastography technology, explore the relationship between the hardness of thrombus and the short-term effect of thrombolytic therapy ,and explore the value of ultrasound elastography strain ratios in predicting thrombolysis effect. Method: 63 patients with acute lower limbs deep venous thrombosis were examined by ultrasound elastography(UE), the elastic strain rations（SRs）which compared the thrombus with surrounding soft tissue were measured. According to the treatment effect after thrombolysis and anticoagulation treatment for 10days, divided the patients into curable group、effective group、ineffective group, and compared the difference of elastic strain ratios among the three groups; combined curable group with effective group into total effective group, contrasted SRs with if the treatment was effective, the two results were built the receive operating characteristic curve(ROC), determined the threshold of thrombolytic therapy was effective or not. Result:（1）There is certain relevance between the hardness of thrombus and effect of thrombolytic therapy. SRs of curable group and effective group is obviously different from ineffective group. There is no obvious difference between SRs of curable group and effective group. （2）SRs of thrombus can be