二维超声及超声弹性成像对类风湿关节炎股四头肌肌腱的评估  

Evaluation of quadriceps tendon in rheumatoid arthritis with two-dimensional ultrasound and ultrasound elastography

作　　者：王挺[1] 黄乐乐[1] 张思功[1] 刘婷[1] 王媛[1] 王引弟[1] WANG Ting;HUANG Le-le;ZHANG Si-gong;LIU Ting;WANG Yuan;WANG Yin-di(Lanzhou University Second Hospital,Lanzhou 730030,China)

机构地区：[1]兰州大学第二医院

出　　处：《中国临床医学影像杂志》2020年第1期57-60,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨超声弹性成像(Ultrasound elastography,UE)在类风湿关节炎(Rheumatoid arthritis,RA)活动期中评估股四头肌肌腱损伤的应用价值。方法:选取40例健康志愿者(对照组)及40例RA患者,参照跟腱分段方法将股四头肌腱分为近段、中段、末段。分别使用二维超声和UE对两组的股四头肌肌腱进行检查,记录结果并进行分级,可分为Ⅰ级、Ⅱ级及Ⅲ级,Ⅰ级肌腱视为正常肌腱,Ⅱ级及Ⅲ级肌腱视为异常或受损肌腱。通过两位评估者对肌腱超声诊断分级进行一致性检验。应用SPSS 22.0对数据进行统计分析。结果 :二维超声在对照组和RA活动组股四头肌肌腱各段分级异常数目中无统计学差异(P=0.173,P=0.072,P=0.242);UE股四头肌肌腱近段分级异常数目在两组中无显著的统计学差异(P=0.093),在中段和末段分级异常数目中有显著的统计学差异(P=0.002,P=0.001)。两组在评估肌腱二维超声诊断分级的一致性较好,对照组(k=0.794,k=0.851,k=0.726),RA活动组(k=0.707,k=0.709,k=0.703);两组在UE诊断分级近段肌腱一致性中等,对照组(k=0.576),RA活动组(k=0.574),两组在中、末段肌腱一致性较好,对照组(k=0.739,k=0.717),RA活动组(k=0.710,k=0.723)。结论:UE在评估RA活动期患者中、末段股四头肌肌腱损伤中有良好的应用价值;UE可以提供RA活动期中股四头肌肌腱硬度信息,可做为二维超声的补充检查方法。Objective: To investigate the value of ultrasound elastography(UE) in assessing quadriceps tendon injury of active period in rheumatoid arthritis(RA). Methods: Forty healthy volunteers(control group) and forty RA patients were selected.The quadriceps tendons were divided into proximal, middle, and distal segments. According to the achilles tendon segmentation method. Using two-dimensional ultrasound and UE to examine the quadriceps tendon of the knee joint, and the results were recorded and graded. Quadriceps tendon can be divided into grade Ⅰ, grade Ⅱ, and grade Ⅲ. Grade Ⅰ tendons were considered as normal tendons, and grade Ⅱ and grade Ⅲ tendons were considered as abnormal or damaged tendons. Consistency test for tendon ultrasound diagnostic grading were evaluated by two evaluators. SPSS 22.0 was used for statistical analysis of data. Results: The number of abnormal quadriceps tendon of each segment detected by two-dimensional ultrasound was not statistically significant between the control group and the RA active group(P=0.173, P=0.072, P=0.242). The number of abnormal quadriceps tendon of proximal segments detected by UE was not statistically significant between the two groups(P=0.093),thus, there was a statistically significant difference in the number of abnormal quadriceps tendon of middle and distal segments(P=0.002, P=0.001). The two groups had better consistency in assessing tendon grading by two-dimensional ultrasound,the control group(k=0.794, k=0.851, k=0.726), and the RA active group(k=0.707, k=0.709, k=0.703);The two groups were moderately consistent of grading of tendon of the proximal segments by UE, the control group(k=0.576), and the RA active group(k=0.574). The two groups had better consistency in the middle and distal segments of the tendon, the control group(k=0.739, k=0.717), and the RA active group(k=0.710, k=0.723). Conclusion: UE is useful in evaluating middle and distal segments quadriceps tendon injury in active RA patients;UE can provide quadriceps tendon stiffness inform

关 键 词：关节炎 类风湿 超声检查 

分 类 号：R593.22[医药卫生—内科学] R445.1[医药卫生—临床医学]