健康人群四肢近端肌肉剪切波弹性成像测量的初步研究

Shear wave elastography measurement of proximal limb muscles in healthy people:a preliminary study

目的测量健康人群四肢近端肌肉剪切波速度,分析与其相关的因素。方法选取2019年1月至2020年12月在四川大学华西医院招募的健康志愿者88例,记录受检者的性别、年龄、体质量指数(BMI)及运动习惯。测量不同肌肉(三角肌、肱二头肌、股直肌、股外侧肌)左右两侧及相同肌肉不同断面、不同位置及不同体位的剪切波速度,并对不同性别、年龄、BMI及运动状态的肌肉剪切波速度进行比较。随机抽取20例受试者,计算三角肌及股直肌剪切波速度测量的观察者间及观察者内一致性。结果各肌肉纵断面剪切波速度左、右两侧比较,差异无统计学意义(P均>0.05)。各肌肉剪切波速度纵断面均大于横断面(P均<0.05)。肱二头肌伸直位纵断面,其剪切波速度肌腹外侧大于肌腹内侧(P均<0.05)。肱二头肌剪切波速度伸直位均大于屈曲位(P均<0.05)。三角肌、肱二头肌剪切波速度男性高于女性(P均<0.05)。股外侧肌剪切波速度18~49岁组高于50~70岁组(P<0.05)。肱二头肌剪切波速度BMI<18.5 kg/m^(2)组及18.5 kg/m^(2)≤BMI<24 kg/m^(2)组均高于BMI≥24 kg/m^(2)组,差异均有统计学意义(P均<0.05)。三角肌剪切波速度规律运动者高于少运动者,差异有统计学意义(P<0.05)。三角肌及股直肌的剪切波速度观察者内及观察者间一致性均为良好或优秀(ICC均>0.88)。结论剪切波弹性成像(SWE)能够用于定量测量健康人群肌肉的硬度值,肌肉的断面和部位及受检者的体位、性别、年龄、BMI和运动习惯为与其相关的因素,研究结果为特发性炎性肌病的进一步研究提供了依据。

Objective To measure the shear wave velocities of proximal limb muscles in healthy people and analyze the related factors.Methods A total of 88 healthy volunteers recruited from West China Hospital of Sichuan University from 2019 to 2020 were selected,and their gender,age,body mass index(BMI),and exercise habits were recorded.The shear wave velocities of different muscles(triangle,biceps brachialis,rectus femoris,and lateral femoral muscle)on both the left and right sides and in different sections,different positions,and different body positions were measured,and the shear wave velocities of the muscles between different genders,ages,exercise status,and BMIs were compared.Twenty subjects were randomly selected to calculate the inter-observer and intra-observer consistency of shear wave velocity measurements of the triangle and rectus femoris muscles.Results There was no significant difference in shear wave velocities between the left and right sides of each muscle in longitudinal section(P>0.05).The shear wave velocities of all muscles were higher in longitudinal section than in cross section(P<0.05).The shear wave velocities of the biceps brachii muscles at the extended long axis section were higher on the lateral side than medial side(P<0.05).The shear wave velocities of the biceps brachii in extensor position were higher than those in flexion position(P<0.05).The shear wave velocities of lateral femoral muscles were higher in the 18~49 age group than in the 50~70 age group(P<0.05).The shear wave velocities of the biceps brachii were significantly higher in the BMI<18.5 kg/m^(2) group and 18.5 kg/m^(2)≤BMI<24 kg/m^(2) group than in the BMI≥24 kg/m^(2) group(P<0.05).The shear wave velocities of the triangular muscles was higher in people with regular exercise than in those with less exercise(P<0.05).The intra-observer and interobserver consistency of shear wave velocities of the deltoid and rectus femoris muscles was good or excellent(ICC>0.88).Conclusion Shear wave elastography can be used to quantitatively measure the hardness value of muscles in healthy people,and the section and position of the muscle and the body position,gender,age,BMI,and exercise habit of people are factors related to such measurements.Our results provide a basis for the in-depth study of idiopathic inflammatory myopathies.