实时剪切波超声弹性成像技术评估帕金森病患者上肢肌张力的临床研究

Shear-wave ultrasound elasticity imaging in upper-limb muscle tone in Parkinson's disease

目的研究帕金森病患者肱二头肌、肱桡肌杨氏模量值特征,探讨实时剪切波超声弹性成像技术评估帕金森病患者肌张力状况的应用价值。方法连续选取2013年5月至2013年10月在首都医科大学附属北京天坛医院神经内科帕金森病专科确诊的帕金森病患者46例,年龄(47.9±2.8)岁,健康志愿者31例,年龄(46.7±3.2)岁。使用法国Supersonnic公司的AixPlore型实时定量剪切波弹性成像超声诊断仪,L4-15线阵探头,获取帕金森病患者双侧、对照组右侧的肱二头肌及肱桡肌松弛状态下长轴杨氏模量值,探讨正常人及帕金森病患者、帕金森病患者症状明显侧与对侧肱二头肌、肱桡肌杨氏模量值差异。结果松弛状态下帕金森病患者症状明显侧、对侧及对照组肱二头肌长轴杨氏模量值分别为(59.94±20.91)kPa、(47.77±24.00)kPa和(24.44±5.09)kPa,帕金森病患者双侧肱二头肌杨氏模量值均高于健康对照组(P<0.05),帕金森病患者症状明显侧肱二头肌长轴杨氏模量值高于对侧(P<0.05);松弛状态下帕金森病患者症状明显侧、对侧及对照组肱桡肌长轴杨氏模量值分别为(32.18±17.19)kPa、(28.41±13.19)kPa和(21.71±7.45)kPa,帕金森病患者两侧肱桡肌杨氏模量值均高于健康对照者(P<0.05),但帕金森病患者两侧肱桡肌长轴杨氏模量值差异无统计学意义(P>0.05)。结论实时定量剪切波弹性成像技术可检测帕金森病患者肱二头肌、肱桡肌杨氏模量值差异,为帕金森病患者肌张力状态评估提供一种新的检测方法。

Objective To investigate the Young＆#39;s modulus of the biceps brachii and brachioradialis in Parkinson＆#39;s disease（ PD） with quantitative shear-wave ultrasound elasticity technique, and to observe the value of elastography in PD. Methods A shear-wave elasto-sonography（Aixplorer model, Supersonic Imaging, France） coupled with a linear array transducer array（4~15 MHz） was employed. Shear-wave ultrasound elasticity imaging of biceps brachii and brachioradialis longitudinal section were performed in 46 patients with Parkinson＆#39;s disease〔mean age（47. 9±2. 8） years〕 in both sides and 31 healthy controls〔mean age（46. 7±3. 2） years〕 in right arm. The quantitative elasticity values were compared among the patients＆#39; symptomatic side, another side（non/mild symptom） and the controls. Results The Young＆#39;s modulus of biceps brachii in symptomatic side, another side of patients and controls were（59. 94±20. 91）kPa, （47. 77±24. 00）kPa and（24. 44±5. 09）kPa, the mean elasticity modulu values of the biceps brachii longitudinal section of PD patients were greater in both sides than those of control group（P〈0. 05）, and the mean value of the biceps brachii in symptomatic side was higher than that of another side（P〈0. 05）. The mean Young＆#39;s modulus of biceps brachii in symptomatic side, another side of patients and controls was（32. 18±17. 19）kPa, （28. 41±13. 19） kPa and（21. 71±7. 45） kPa, the mean elasticity modulus of the brachioradialis longitudinal section of PD patients were greater in both sides than those of control group（P〈0. 05）, but there was no significant difference in the symptomatic side and another side of PD patients（P〉0. 05）. Conclusion Shear-wave ultrasound elasticity imaging can find the characteristics of the elastic modulus of the biceps brachii and brachioradialis longitudinal section, providing a new method to assess the muscle tone in PD.