自体肌腱移植术后半腱肌肌腱再生状态的超声剪切波弹性评估

Shear Wave Elastography Evaluation of Regeneration of Semitendinosus Tendon Following Semitendinosus Tendon Harvest for Anterior Cruciate Ligament Reconstruction

目的:应用多模态超声技术评估自体半腱肌腱和股薄肌腱重建前交叉韧带术后,患者半腱肌肌腱的再生状态。方法:连续检查单侧自体半腱肌腱重建前交叉韧带术后患者53人,术后时间11周~8年。进行双侧半腱肌肌腱超声对比扫查,记录"再生"肌腱最大厚度、最大截面积、回声特征,取腱沟处剪切波传播速度数值。结果:1、34/53例超声显示出现"再生"肌腱,再生率为64.15%。2、"再生"肌腱厚度均值(0.35±0.09 cm)高于对侧正常肌腱(0.24±0.04 cm)(P<0.001),"再生"肌腱截面积(0.22±0.11cm2)大于对侧正常肌腱(0.14±0.04 cm2)(P=0.001)。3、53例取腱沟处组织剪切波传播速度(5.61±2.48 m/s)低于对侧正常肌腱剪切波传播速度(12.50±2.25 m/s)(P<0.001)。34例"再生"肌腱剪切波传播速度(6.73±2.31 m/s)低于对侧正常肌腱剪切波传播速度(13.06±1.61 m/s)(P<0.001)。4、34例"再生"肌腱的厚度、横截面积、剪切波传播速度与术后时间无相关(P>0.05)。结论:自体半腱肌肌腱和股薄肌腱重建前交叉韧带术后,半腱肌再生发生率较高,其再生半腱肌肌腱厚度及截面积均大于正常,而剪切波传播速度低于正常肌腱,提示弹性尚未恢复正常。

Objective To evaluate the regeneration of semitendinosus tendons after the anterior cruci-ate ligament（ACL） reconstruction using the multimodal ultrasound. Methods Fifty-three patients under-going the unilateral ACL reconstruction from 11 weeks to 8 years ago, were examined using the ultra-sound. Double-side semitendinosus tendons examinations were performed to record the thickness, cross-sectional area and velocity of the shear wave propagation. Results The rate of semitendinosus tendon re-generation was 64.15%（34/53） evaluated by ultrasound. The average regeneration tendons thickness was（0.35 ± 0.09 cm）, higher than the normal tendons of（0.24 ± 0.04 cm）（P〈0.001）. Moreover, the cross-sectional area of the regeneration tendons（0.22 ± 0.11 cm^2） was greater than that of the oppositehealthy ones（0.14 ± 0.04 cm^2）（P〈0.001）. The velocity of shear wave propagation of regeneration ten-dons（6.73 ± 2.31 m/s） was lower than that of normal ones（13.06 ± 1.61 m/s）（P〈0.001）. None of the parameters were correlated with the time. Conclusion Compared with the normal, the regeneration semi-tendinosus tendons were of hypertrophy and a slower velocity of shear wave propagation, indicating alack of normal elasticity.