超声弹性成像在评价脑卒中后单侧下肢运动障碍患者康复训练后跟腱恢复功能的价值  

Real-time Ultrasound Elastography(RTE)Evaluation on the Function Recovery of Achilles Tendon in Patients with Mild Hemiplegic Stroke

作　　者：邵玉红[1] 孔迅[1] 彭泽[1] 谢斌[2] 王彬[1] 张惠[1] 孙秀明[1] 

机构地区：[1]北京大学第一医院超声科 [2]北京大学第一医院康复医学科

出　　处：《中国超声医学杂志》2017年第2期166-169,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨对脑卒中合并单侧下肢运动障碍患者,应用超声弹性成像技术评价其康复训练前后跟腱功能恢复情况的价值。方法选择22例成人脑卒中后合并单侧下肢运动障碍的患者,以其患侧跟腱为病例组,对侧健康跟腱作为对照组,在康复中心行跖屈肌群牵伸训练9周。对训练前双侧跟腱及训练后患侧跟腱行超声检查,分别记录跟腱长度、厚度、RTE分级及弹性应变率比值并进行统计学分析。结果 22例患者康复训练前患侧跟腱与健侧比较:长度增加[(71.9±13.4)mm vs(58.1±11.1)mm,P=0.002],RTE分级Ⅰ级数量减少(59.1%vs.90.9%,P=0.015),弹性应变率比值降低(2.90±0.84vs 3.51±0.61,P=0.009)。9周的训练后跟腱长度缩短[(71.9±13.4)mm vs(63.3±12.8)mm,P=0.023],Ⅰ级跟腱数增加(59.1%vs.86.4%,P=0.042),弹性应变率比值增加(2.90±0.84vs 3.38±0.66,P=0.041)。结论超声联合RTE能够很好地评价脑卒中患者跟腱受损情况,客观地反映康复训练前后跟腱的生物力学特性变化,有效评价康复训练疗效,指导临床康复治疗。Objective To evaluate the function recovery of Achilles tendon after rehabilitation in the patients with stroke and unilateral lower limb movement disorder, using RTE. Methods Prospectively collect the patients with 6 to 12-month duration of mild hemiplegic stroke. All patients underwent 9-week rehabilitation training including passive-stretching and active-movement. The two-dimensional ultrasound （2DUS） and RTE features of the impaired and con tralateral normal Achilles tendon were measured at pre-training, 9 weeks after training in each patient, including tendon length, thickness, elasticity grade （Grade I-III ）, fat-to-tendon strain ratio. Results 22 patients were enrolled in a 6-month study period. Before training, the impaired Achilles tendon had longer length （P=0. 002）, lower frequen cies of Grade I （P= 0. 015）, and lower fat-to-tendon strain ratio （P= 0. 009） compared to contralateral normal tendon. Pre-training impaired tendons were compared to post-training tendons at 9th week, which showed decreased length （P= 0. 023）, increased frequencies of grade elasticity I （P = 0. 042）, and fat-to-tendon strain ratio （P = 0. 041）. Conclusions The 2DUS and RTE provide valuable imaging markers, which may quantitatively evaluate the functional recovery of the Achilles tendon over the training time in patients with mild hemiplegic stroke.

关 键 词：超声 弹性成像 跟腱 脑卒中 

分 类 号：R445.1[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]