超声成像测量不同姿势下腓肠肌形态的信度

Reliability of Morphological Measurement of Gastrocnemius Using Ultrasonography in Different Positions

目的探讨肌肉骨骼超声测量站立位和俯卧位下人体腓肠肌内侧肌结构参数的信度,并比较不同姿势下腓肠肌内侧肌结构参数的差异。方法 2017年12月至2018年5月,由2名操作者使用肌肉骨骼超声分别获取健康青年人30例俯卧位和站立位右侧腓肠肌内侧肌超声图片,测量肌肉厚度、肌纤维长度和羽状角。3 d后由其中一名操作者使用同样的方法测量。计算组内相关系数(ICC)、测量标准误差(SEM)和最小可检测变化值(MDC),比较两种姿势下参数的差异。结果俯卧位下测试者间ICC=0.932~0.943,重测ICC=0.880~0.915;站立位下测试者间ICC=0.922~0.938,重测信度ICC=0.839~0.925。俯卧位和站立位下,肌肉厚度、肌纤维长度和羽状角有非常显著性差异(P <0.01)。站立位下测试者间SEM小于俯卧位,俯卧位下重测MDC小于站立位。结论超声测量站立位及俯卧位下腓肠肌内侧肌的结构参数具有良好的信度;腓肠肌形态学测量站立位更准确,俯卧位更敏感。

Objective To investigate the reliability of the morphological measure of medial gastrocnemius by musculoskeletal ultrasound imaging on the standing and prone positions, and compare the differences in the structural parameters of the medial gastrocnemius in different positions.Methods From December, 2017 to May, 2018, 30 healthy young subjects were measured the muscle thickness, fascicle length and pennation angle of medial gastrocnemius on the prone and standing position respectively by two testers with musculoskeletal ultrasound. One of the testers re-tested three days later. The intra-class correlation coefficient(ICC), measurement standard error(SEM) and minimum detectable change(MDC) of all muscle morphological parameters in different positions were calculated respectively, and the differences of the morphological measurement of the medial gastrocnemius between these two positions were compared.Results In the prone position, the ICC of inter-rater was 0.932 to 0.943 and the ICC of intra-rater was 0.880 to 0.915. In the standing position, the ICC of inter-rater was 0.922 to 0.938, and the ICC of intra-rater was 0.839 to 0.925.There were significant differences in muscle thickness, fascicle length and pennation angle of medial gastrocnemius in standing position and prone position(P < 0.01). Inter-rater SEM of muscle thickness and fascicle length was less in standing position than in prone position, while intra-rater MDC of pennation angle was less in prone position.Conclusion It is reliable to measure medial gastrocnemius in standing and prone positions with ultrasonography. Morphological measurement of gastrocnemius is more accurate in standing position, while the measurement in prone position is more sensitive.