二维剪切波弹性成像评估血液透析患者肱二头肌受损情况

Evaluation of biceps brachii muscle damage in maintenance hemodialysis patients by two-dimensional shear wave elastography

目的 应用二维剪切波弹性成像(2D-SWE)评估维持性血液透析患者肱二头肌受损情况。方法 选取在我院行维持性血液透析患者60例,根据透析时间不同分为长透析龄组(血液透析时间5~20年)和短透析龄组(血液透析时间<5年),每组各30例,另选同期30例健康体检者作为对照组。应用常规超声测量各组右、左侧肱二头肌中段肌肉厚度和浅侧脂肪厚度,2D-SWE测量各组肱二头肌中段剪切波速度,比较各组上述指标的差异。结果 各组右、左侧肱二头肌肌肉厚度比较差异均无统计学意义;各组右、左侧肱二头肌浅侧脂肪厚度比较差异有统计学意义(P<0.05),且短透析龄组右、左侧肱二头肌浅侧脂肪厚度均较对照组薄,差异均有统计学意义(均P<0.05)。长透析龄组右、左侧肱二头肌肌肉及浅侧脂肪剪切波速度分别为(3.17±0.27)m/s及2.88(2.73,3.07)m/s、(3.17±0.33)m/s及2.85(2.69,3.07)m/s,短透析龄组分别为(3.48±0.24)m/s及3.08(3.00,3.20)m/s、(3.47±0.26)m/s及3.09(2.97,3.27)m/s,对照组分别为(3.76±0.19)m/s及3.22(3.14,3.36)m/s、(3.72±0.25)m/s及3.27(3.15,3.38)m/s,各组两两比较差异均有统计学意义(均P<0.05)。结论 2D-SWE可用于评估维持性血液透析患者肱二头肌受损情况。

Objective To evaluate the biceps brachii muscle damage in maintenance hemodialysis patients by two dimensional shear wave elastography(2D-SWE).Methods Sixty patients underwent maintenance hemodialysis in our hospital were selected and divided into long-term dialysis group(5~20 years)and short-term dialysis group(<5 years)according to different dialysis ages,each group included 30 cases.Additionally,30 healthy individuals underwent routine physical examinations during the same period were selected as the control group.Conventional ultrasound was used to measure the muscle thickness and subcutaneous fat thickness of the biceps brachii muscle on the right and left sides in each group.2D-SWE was used to measure the shear wave velocity of the middle of biceps brachii muscle in each group.Differences in the above indicators among the groups were compared.Results There were no statistically significant differences in the muscle thickness of right and left biceps brachii muscle among the groups.However,the differences in the subcutaneous fat thickness of right and left biceps brachii muscle were statistically significant(all P<0.05).In the short-term hemodialysis group,the subcutaneous fat thickness of right and left biceps brachii muscle were thinner than those in the control group,and the differences were statistically significant(both P<0.05).In the long-term group,the shear wave velocity of right and left biceps brachii muscle and superficial adipose tissue anterior to the biceps brachii were(3.17±0.27)m/s and 2.88(2.73,3.07)m/s,(3.17±0.33)m/s and 2.85(2.69,3.07)m/s,respectively.In the short-term group,the shear wave velocity of right and left biceps brachii muscle and superficial adipose tissue anterior to the biceps brachii were(3.48±0.24)m/s and 3.08(3.00,3.20)m/s,(3.47±0.26)m/s and 3.09(2.97,3.27)m/s,respectively.In the control group,the shear wave velocity of right and left biceps brachii muscle and superficial adipose tissue anterior to the biceps brachii were(3.76±0.19)m/s and 3.22(3.14,3.36)m/s,(3.72±0.25)m/s and 3.27(3.15,3.38)m/s.There were statistically significant differences in pairwise comparison(all P<0.05).Conclusion 2D-SWE can be used to evaluate biceps brachii muscle damage in maintenance hemodialysis patients.