摘要
多发性大动脉炎(TA)是一种常发生在主动脉及其主要分支的慢性非特异性炎症疾病。患者往往起病隐匿,导致误诊率高,待确诊时已发生受累动脉狭窄或闭塞,并引发动脉管腔缺血、缺氧症状,重症者将危及生命。超声造影(CEUS)是分析TA的新兴方法,分析手段主要依赖医生的经验进行人工定性分析,因此诊断结果常有失精准。基于此,本文提出一种TA颈动脉病变CEUS的计算机辅助定量分析方法:首先在颈动脉壁上勾勒TA病灶的轮廓,在颈动脉管腔中选取匀质的矩形和多边形各一个作为参考区域;然后分别求出病灶区域与参考区域的时域特征和空域特征,并计算病灶与参考区域间特征的差值和比值,作为新的特征;最后分析所有特征与炎症指标血沉(ESR)和C反应蛋白(CRP)间的相关性。本文选取中山医院就诊的34例TA患者的共37个接受CEUS检查的颈动脉受累病灶,其中2例患者各有治疗前后两个病灶,1例患者有左右双侧病灶;这些患者中有13例为未经治疗的初发患者,共14个病灶,其中1例有左右双侧病灶。结果表明,全体患者的病灶内部1/3区域中新生血管面积比(ARi_(1/3))与CRP的相关系数r值达0.56(P=0.001),初发患者的病灶内部1/2区域中新生血管面积比(ARi_(1/2))与CRP的r值达0.76(P=0.001)。本文研究说明,所提出的计算机辅助方法能从CEUS图像中客观、半自动地提取TA病变的定量特征,减轻医生主观经验对诊断的影响,今后有望用于临床上TA颈动脉病变的诊断判别与严重程度评估。
Takayasu arteritis （TA） is a chronic nonspecific inflammation that commonly occurs in the aorta and its main branches. Most patients with TA are lack of clinical manifestations, leading to misdiagnosis. When the TA is correctly diagnosed, the patients may already have stenosis or occlusion in the involved arteries, resulting in arterial ischemia and hypoxia symptoms, and in severe cases it will be life-threatening. Contrast-enhanced ultrasonography （CEUS） is an emerging method for assessing TA, but the assessment relies heavily on experiences of radiologists performing manual and qualitative analyses, so the diagnostic results are often not accurate. To overcome this limitation, this paper presents a computer-assisted quantitative analysis of TA carotid artery lesions based on CEUS. First, the TA lesion was outlined on the carotid wall, and one homogeneous rectangle and one polygon were selected as two reference regions in the carotid lumen. The temporal and spatial features of the lesion region and the reference regions were then calculated. Furthermore, the difference and ratio of the features between the lesion and the reference regions were computed as new features （to eliminate interference factors）. Finally, the correlation was analyzed between the CEUS features and inflammation biomarkers consisting of erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP）. The data in this paper were collected from 34 TA patients in Zhongshan Hospital undergoing CEUS examination with a total of thirty-seven carotid lesions, where two patients were with two lesions before and after treatment and one patient was with left and right bilateral lesions. Among these patients, 13 were untreated primary patients with a total of 14 lesions, where one patient was with bilateral lesions. The results showed that for all patients, the neovascularization area ratio in the 1/3 inner region of a lesion （ARil/3） achieved a correlation coefficient （r） of 0.56 （P--0.001） with CRP, and for the prima
出处
《生物医学工程学杂志》
EI
CAS
CSCD
北大核心
2017年第5期790-796,共7页
Journal of Biomedical Engineering
基金
国家自然科学基金面上项目(61671281)
国家自然科学基金青年科学基金项目(61401267)
关键词
多发性大动脉炎
超声造影
特征提取
定量分析
颈动脉
Takayasu arteritis
contrast-enhanced ultrasound
feature extraction
quantitative analysis
carotid artery
