Value Of Three-dimensional Color Doppler Ultrasonography Volume Method In Evaluating The Extent Of The Artery Stenosis

Objective:In this paper, we use the three-dimensional ultrasound volumetric method to evaluate the arterial stenosis of Peripheral Arterial Disease, to compared the measurements of the two-dimensional ultrasound area method and the three-dimensional ultrasound volume method, and study the value of three-dimensional Color Doppler ultrasonography volume method in evaluating the extent of the artery stenosis.Methods:This study selected 30 patients with Peripheral Arterial Disease,47 of the limbs, 230 sections of lesion segments. To chose the sections of relatively uniform stenotic artery segment. We used the two-dimensional ultrasound diameter method to determine the extent of artery stenosis.(The sections were selected Including 30 segments of mild stenosis, 30 segments of moderate stenosis , 30 segments of severe stenosis) . The length of each stenotic artery segment is 5cm. The degree of stenosis of the same stenotic artery segment was measured by the two-dimensional ultrasound area method and the three-dimensional ultrasound volume method . The two-dimensional ultrasound diameter method : Examing along the long axis of the vascular , to measure artery stenosis's out diameter (D) and residual vascular lumen's internal diameter (d). Then we used the software of the ultrasonic Instrument to calculate the diameter stenosis rate . The two-dimensional ultrasound area method: Examing along the short axis view of the vascular by parallel order, to measure stenosis Lumen area (s), the area of original artery stenosis lumen(S). Then we calculated the area stenosis rate by the formula. The three-dimensional ultrasound volume method: examining along the direction of the vascular. Firstly, ensure to acquire each piece 0f satisfactory two-dimensional image (gray scale ultrasound and Color Doppler ultrasound ) . Secondly, we started the key of 3D and got a image of four pictures in one same screen . In QLAB workstation we entered the analysis software of GI3DQ , we used the thick volume slicing technique in vascular axis image, on artery lesions selected divided the number of slices, then on the plane image we accurately crochet the every piece of vascular cross-section image. Finally, we acquired a three-dimensional vascular image of the current vessel. The vascular volume and the volume stenosis rate display on the right of the screen. All statistical analyses were recorded ,and analyzed by SPSS 17.0 for windows .The results were expressed by means±standard deviation, inter-group comparison was tested by t-test(P<0.05:statisticl significance). All measurement results of three methods were analyzed by consistency test Kappa.Results:The two-dimensional ultrasound area method compared with the two-dimensional ultrasound diameter method , the measurements of the mild stenosis group and the severe stenosis group have no statistics significance ( p>0.05 ) , the moderate stenosis group's average value increased obviously(p<0.05). The three-dimensional ultrasound volume method compared with the two-dimensional ultrasound diameter method, the three groups of artery stenosis's measurements have no statistics significance (p>0.05). The Kappa of the three-dimensional ultrasound volume method compared with the two-dimensional ultrasound diameter method is 0.942, the Kappa of the two-dimensional ultrasound area method compared with the two-dimensional ultrasound diameter method is 0.860. The compliance rate of the two-dimensional ultrasound area method,the three-dimensional ultrasound volume method and the two-dimensional ultrasound diameter method is 80%-100%. There are 18 Segments'measurements are higher than the measurements of the two-dimensional ultrasound diameter method, when measured by the two-dimensional ultrasound area method, and there is 1 segment's measurement is lower than measurements of the two-dimensional ultrasound diameter method.Results:The following conclusions from the results of this study : 1. The three-dimensional ultrasound volume method can evaluate the extent of the artery stenosis of ASO. It combines with the two-dimensional ultrasound diameter method, and complements each other, as a new method for evaluating the extent of the artery stenosis. The new method can more accurater evaluate the extent of the artery stenosis. 2. The measurements of the three-dimensional ultrasound volume method has the better consistency with the measurements of the two-dimensional ultrasound diameter method than the two-dimensional ultrasound area method. 3. The three-dimensional ultrasound volume method compared with the two-dimensional ultrasound diameter method, when measuring the mild stenosis group and the moderate stenosis group, the extent of artery stenosis were overestimated. 4.The three-dimensional ultrasound volume method still need to be improved.In sum, The three-dimensional ultrasound volume method provide a new and noninvasive method for evaluating the extent of the artery stenosis of ASO; The three-dimensional ultrasound volume method is a supplement for the two-dimensional ultrasound diameter method. The two methods combined can quantitatively evaluate the extent of the artery stenosis. It can provide more complete, three-dimensional, objective, truthful Information of stenosis artery, and help to judge the severity of stenosis artery. In order to make a accurate preoperative evaluation and choose exactly clinical treatment.