声辐射力脉冲成像对存在肌间静脉丛扩张的小腿后侧肌群弹性定量评估的价值

doi:10.3969/j.issn.2095-9400.2020.02.006

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1374 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的：探讨应用声辐射力脉冲成像（ARFI）技术评估存在肌间静脉扩张的小腿后侧肌群弹性变化。方法：收集2017年10月至2018年6月在温州医科大学附属第二医院行双下肢静脉超声检查的受检者74例，选择存在小腿后侧肌群肌间静脉丛扩张者为病例组，共48例，66条小腿。按病变累及范围分组，其中病例组1为腓肠肌内侧头（MG）和比目鱼肌（SOL）均存在肌间静脉丛扩张，患者24例，33条小腿；病例组2为仅存在SOL肌间静脉丛扩张，患者24例，33条小腿。对照组为腓肠肌和SOL均不存在肌间静脉丛扩张，共26例，52条小腿。所有受检者均使用ARFI技术的声触诊组织量化（VTQ）模式分别在踝关节自然位、最大跖屈位、最大背屈位3种体位下测量小腿MG、腓肠肌外侧头（LG）、SOL的剪切波速度（SWV）。比较各组间的SWV差异，同时分析每块肌肉在不同体位下获得的SWV的重测信度。结果：在踝关节自然位，病例组1 MG的SWV分别高于病例组2和对照组（P＜0.05），病例组1 SOL的SWV高于对照组（P＜0.05）。在踝关节最大跖屈位，3组间对应肌肉的SWV比较，差异均无统计学意义（P＞0.05）。在踝关节最大背屈位，病例组2 MG的SWV高于对照组（P＜0.05），其余组间对应肌肉的SWV比较，差异均无统计学意义（P＞0.05）。MG、LG在3种体位下获得的SWV重复测量组内相关系数（ICC）均大于0.75，重测信度良好。SOL在3种体位下获得的SWV重复测量ICC处于0.45～0.75之间，重测信度较好。结论：ARFI技术可定量评估存在肌间静脉丛扩张小腿后侧肌群的弹性变化，有可能成为进一步研究小腿后侧肌群肌肉弹性与肌间静脉丛扩张内在联系的重要手段。

	服务
	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	董雁雁
	孙谢璐
	王鹏飞
	徐茂晟
	邹春鹏

关键词 ：超声检查, 弹性成像技术, 肌, 骨骼, 静脉丛

Abstract：Objective: To investigate the elastic changes of triceps surae with venous plexus dilatation by acoustic radiation force impulse imaging (ARFI). Methods: A total of 74 subjects who underwent double-limb venous ultrasonography at the Second Affiliated Hospital of Wenzhou Medical University from October 2017 to June 2018 were collected. Patients with triceps surae venous plexus dilatation were selected as the case group, in which a total of 48 patients (66 legs) were collected. According to the extent of venous plexus dilatation involvement, the case group was divided as Group One, in which patients had venous plexus dilatation in both medial gastrocnemius (MG) and soleus and Group Two, in which patients only had soleus venous plexus dilatation, with each group having 24 patients (33 legs). Twenty-six individuals (fifty two legs) were collected as the control group who didn’t have venous plexus dilatation in either gastrocnemius or soleus. All subjects underwent ARFI imaging in virtual touch tissues quantification (VTQ) model to obtain the value of shear wave velocity (SWV) of triceps surae which contains MG, lateral gastrocnemius (LG) and soleus (SOL) at three different positions including the natural position, the maximum metatarsal flexion position and the maximum dorsiflexion position of the ankle joint. A comparison was made between different groups at the same position in the value of SWV. Meanwhile, the test-retest reliability of SWV was also analyzed. Results: In natural position of the ankle joint, SWV value of MG obtained in Group One was higher than Group Two and the control group (P<0.05); SWV value of SOL obtained in Group One was higher than the control group (P<0.05). In maximum metatarsal flexion position of the ankle joint, there was no significant difference in SWV value of each muscle among the three groups (P>0.05). In maximum dorsiflexion position of the ankle joint, SWV value of MG obtained in Group Two was higher than the control group (P<0.05), while all other differences between the groups were not statistically significant (P>0.05). The SWV of MG and the SWV of LG both had excellent test-retest reliability as intraclass correlation coefficient (ICC) calculation of three different positions were all larger than 0.75. And ICC calculation of the SWV of SOL at three different positions were between 0.45-0.75. Conclusion: ARFI can be used to quantitatively evaluate the elastic changes of triceps surae with venous plexus dilatation, which may become an important technique to further study the intrinsic relationship between the muscle elasticity and the triceps surae venous plexus dilatation disease.

Key words： ultrasonography elasticity imaging techniques muscle, skeletal venous plexus

基金资助:温州市基础性科研项目（Y20180763）。

通讯作者: 邹春鹏，副主任医师，Email：chpzou@126.com。

作者简介: 董雁雁（1991-），女，浙江苍南人，住院医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/10.3969/j.issn.2095-9400.2020.02.006 或 https://xb.wmu.edu.cn/CN/Y2020/V50/I2/115

[1] GALANAUD J P, SEVESTRE M A, GENTY C, et al. Incidence and predictors of venous thromboembolism recurrence after a first isolated distal deep vein thrombosis[J]. J Thromb Haemost, 2014, 12(4): 436-443.
[2] MIN S K, KIM Y H, JOH J H, et al. Diagnosis and treatment of lower extremity deep vein thrombosis: Korean Practice Guidelines[J]. Vasc Specialist Int, 2016, 32(3): 77-104.
[3] CHINO K, KAWAKAMI Y, TAKAHASHI H. Tissue elasticity of in vivo skeletal muscles measured in the transverse and longitudinal planes using shear wave elastography[J]. Clin Physiol Funct Imaging, 2017, 37(4): 394-399.
[4] CREZE M, NYANGOH TIMOH K, GAGEY O, et al. Feasibility assessment of shear wave elastography to lumbar back muscles: A Radioanatomic Study[J]. Clin Anat, 2017, 30(6): 774-780.
[5] 王小花, 何慧疗, 姜淑英, 等. 胃癌组织横向剪切波速度与患者临床特征的关系[J]. 温州医科大学学报, 2018, 48(9): 688-690, 693.
[6] 文晶, 王月香, 罗渝昆, 等. 剪切波超声弹性成像定量评估腓肠肌和比目鱼肌硬度的初步研究[J]. 中国医学影像学杂志, 2017, 25(7): 536-540, 542.
[7] 杨寒凝, 陆永萍, 杜静, 等. 实时剪切波弹性成像对正常腓肠肌的定量研究[J]. 中国超声医学杂志, 2017, 33(6): 558-560.
[8] 郭宝生, 任卫东, 杨军, 等. 小腿肌间静脉曲张的超声观察及血流动力学分析[J]. 中国医学影像技术, 2010, 26(5): 863-865.
[9] 于蕾, 宋奕宁, 张珊珊, 等. 彩色多普勒超声探测小腿肌间静脉扩张与单纯肌间静脉血栓的关系[J]. 临床超声医学杂志, 2009, 11(6): 380-382.
[10] HICKEY B A, MORGAN A, PUGH N, et al. The effect of lower limb cast immobilization on calf muscle pump function: a simple strategy of exercises can maintain flow[J]. Foot Ankle Int, 2014, 35(5): 429-433.
[11] MOSTI G, PARTSCH H. A wearable compression device to normalise calf muscle pump function in chronic venous insufficiency for each postural position[J]. Eur J Vasc Endovasc Surg, 2019, 57(5): 702-707.
[12] NAKAMURA M, IKEZOE T, UMEGAKI H, et al. Shear elastic modulus is a reproducible index reflecting the passive mechanical properties of medial gastrocnemius muscle belly [J]. Acta Radiol Open, 2016, 5(4): 2058460115604009.