剪切波弹性成像评价女性膝骨关节炎患者股四头肌弹性模量变化

Evaluation of Elastic Modulus of Quadriceps Femoris in Female Patients with Knee Osteoarthritis Using Supersonic Shear Imaging

目的:通过观察膝关节炎患者股四头肌超声下剪切波弹性模量变化,探讨实时超声剪切波弹性成像技术在评价膝关节炎患者股四头肌生物性能改变中的价值。方法:选取40例确诊为膝骨关节炎的女性患者(观察组)及40例健康女性志愿者(对照组),两组均行超声剪切波弹性成像检查。观察组的患者行下肢肌肉链训练治疗,并在治疗前及治疗后3个月行超声剪切波弹性成像检查。比较观察组与对照组及观察组在治疗前后股直肌、股内侧肌、股外侧肌的弹性模量差异,量化分析女性膝骨关节炎患者下肢肌肉的硬度改变。结果:观察组治疗前的股直肌弹性模量为(7.03±1.07)kPa、股内侧肌(6.87±1.64)kPa、股外侧肌(7.00±1.23)kPa均值均低于对照组股直肌(9.07±1.52)kPa、股内侧肌(7.96±0.94)kPa、股外侧肌(8.33±1.10)kPa,其差异具有统计学意义(P<0.01)。观察组治疗后的股直肌弹性模量为(8.17±1.00)kPa、股内侧肌(7.35±1.11)kPa、股外侧肌(7.80±0.89)kPa均高于治疗前,对比具有统计学意义(P<0.01或P<0.05)。结论:实时超声剪切波弹性成像技术可用于定量评估膝关节炎患者肌肉生物力学性能,为膝骨关节炎的诊断及疗效评定补充了新的观察依据,具有较高的临床应用价值和研究前景。

Objective: To explore the value of real-time ultrasonic shear wave elastic imaging in evaluating the biological properties of quadriceps muscle in patients with knee arthritis by observing the changes of the elastic modulus of shear wave under the ultrasound of those patients’ quadriceps muscle. Methods: 40 female patients diagnosed with knee osteoarthritis (observation group) and 40 healthy female volunteers (control group) were examined by ultrasonic shear wave elastic imaging. The lower extremity muscle chain training treatment was given to the patients belong to the observation group,and ultrasonic shear wave elastic imaging was examined before and 3 months after treatment. The difference of elastic modulus of femoral rectus muscle,medial femoral muscle and lateral femoral muscle before and after treatment was compared between the observation group and the control group. After that,the hardness changes of lower extremity muscle in female knee osteoarthritis patients were quantitatively analyzed. Results: In observation group before treatment the mean elastic modules of femoral rectus muscle (7.03±1.07) kpa,medial femoral muscle (6.87±1.64) kpa,lateral femoral muscle (7.00±1.23) kpa,were lower than that rectus muscle (9.07±1.52) kpa,medial femoral muscle (7.96± 0.94) kpa,lateral femoral muscle (8.33±1.10) kpa in the control group,the difference is statistically significant (P<0.01).After treatment the mean elastic modules of femoral rectus muscle (8.17±1.00) kpa,medial femoral muscle (7.35±1.11) kpa,lateral femoral muscle (7.80±0.89) kpa in the observation group were higher than that before treatment,and the comparison was statistically significant (P<0.01 or P<0.05). Conclusion: The real-time ultrasonic shear wave elastic imaging technique could be used to quantitatively evaluate the biomechanical properties of knee arthritis patients,which supplements the new observation basis for the diagnosis and efficacy evaluation of knee osteoarthritis. It has high clinical application value and research prospect.