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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。
Polyarteriitis (TA) is a chronic nonspecific inflammatory disorder that commonly occurs in the aorta and its major branches. Patients are often insidious onset, resulting in high misdiagnosis rate, to be confirmed when the affected artery stenosis or occlusion has occurred, and lead to arterial ischemia, hypoxia symptoms, critically ill will be life-threatening. Ultrasonography (CEUS) is a new method for the analysis of TA. The analysis methods rely mainly on the experience of doctors to perform qualitative analysis. Therefore, the diagnostic results are often inaccurate. Based on this, this paper presents a computer-assisted quantitative analysis of CEUS of TA carotid lesions: firstly, the outline of TA lesions is outlined on the carotid artery wall, and one homogeneous rectangle and one polygon are selected as the reference area in the carotid lumen; Then, the temporal and spatial features of the lesion and the reference region were calculated, and the differences and ratios between the lesion and the reference region were calculated as the new features. Finally, all the features were analyzed with the ESR and C responses Protein (CRP) between the correlation. In this paper, we selected a total of 37 carotid artery lesions from 34 patients with TA who were treated in Zhongshan Hospital. Two patients had two lesions before and after treatment and one patient had left and right lesions. Thirteen of these patients For untreated patients with initial onset, a total of 14 lesions, including 1 case of bilateral lesions on both sides. The results showed that the r value of ARi_ (1/3) and CRP in the 1/3 area of the lesion in all patients was 0.56 (P = 0.001), and the internal lesion area 1/2 The neovascular area ratio (ARi_ (1/2)) and CRP r values were 0.76 (P = 0.001). This study shows that the proposed computer-assisted method can objectively and semi-automatically extract the quantitative features of TA lesions from CEUS images and reduce the impact of subjective experience on the diagnosis of patients, and is expected to be used in clinical diagnosis and severity of TA carotid lesions Degree assessment.