超声剪切波弹性成像评价脑卒中后下肢运动障碍患者小腿三头肌与跟腱的研究  

Real-time Shear Wave Ultrasound Elastography Evaluation on the Achilles Tendon and Triceps Surae in Patients with Hemiplegic Stroke

作　　者：郭忆[1] 芦海涛[2] 李雪梅[1] 张皓[2] 冯冰[1] 王艺铮[2] Guo Yi;Lu Haitao;Li Xuemei;Zhang Hao;Feng Bing;Wang Yizheng(Department of Ultrasound,Beijing Bo′ai Hospital,China Rehabilitation Research Center,Beijing 100068,China)

机构地区：[1]中国康复研究中心附属北京博爱医院超声科,北京市100068 [2]中国康复研究中心附属北京博爱医院神经内科,北京市100068

出　　处：《中国超声医学杂志》2020年第8期741-744,共4页Chinese Journal of Ultrasound in Medicine

基　　金：2018年中国康复研究中心重点科研项目(No.2018zx-19)。

摘　　要：目的利用超声剪切波弹性成像对脑卒中后伴发单侧下肢运动障碍患者跟腱及小腿三头肌(腓肠肌内、外侧头及比目鱼肌)进行评价,分析临床价值。方法选取51例脑卒中后伴发单侧下肢运动障碍患者,患侧为病例组,健侧为对照组,对双侧跟腱及小腿三头肌进行灰阶超声和剪切波弹性成像检查。分别记录跟腱长度(比目鱼肌肌腱长度为准)、厚度及跟腱与小腿三头肌剪切波速度(SWV)。将患者双侧小腿三头肌牵拉至最大背屈位,后再次进行剪切波弹性成像检测。并进行统计学分析。结果51例患者双侧跟腱比较,患侧跟腱长度较健侧长,跟腱内径无明显差别;剪切波弹性成像比较,患侧跟腱及小腿三头肌剪切波速度明显较健侧增高,硬度明显增加;牵拉后,双侧小腿三头肌剪切波传播速度明显增快(P<0.01)。结论超声剪切波弹性成像可以量化跟腱及小腿三头肌(腓肠肌内、外侧头及比目鱼肌)的弹性特征,可用于指导脑卒中患者的康复治疗。Objective To evaluate the achilles tendon and triceps surae in the patients with stroke and unilateral lower limb movement disorder,real-time shear wave ultrasound elastography was used to compare the Achilles tendon and triceps surae between affected side and uninjured side,and its clinical application value was analyzed.The Achilles tendon and triceps of leg(gastrocnemius,gastrocnemius and soleus)of stroke patients with unilateral lower extremity dyskinesia were evaluated by ultrasonic shear wave elastography,and the clinical application value was analyzed.Methods Collect the patients 51 of hemiplegic stroke.The two-dimensional ultrasound and shear wave velocity(SWV)of the affected side and uninjured side achilles tendon and triceps surae were measured in each patient,including tendon length,thickness,shear wave velocity of achilles tendon and triceps surae.Then after tractive both side triceps surae,respectively,shear wave velocity of triceps surae were performed.Results 51 patients were enrolled.the affected side had longer length(P<0.01)than contralateral normal achilles tendon.And there was no difference in thickness between affected side and uninjured side(P>0.05).Compare with the uninjured side,there were higher shear wave velocity in affected side achilles tendon and triceps surae(P<0.01);After tractive,shear wave velocity were higher in achilles tendon and triceps surae both side than before.Conclusions Real-time shear wave ultrasound elastography can quantitatively evaluate the elastic characteristic of the achilles tendon and triceps surae,which may evaluate the functional recovery in patients with hemiplegic stroke.

关 键 词：剪切波弹性成像 脑卒中 跟腱 小腿三头肌 

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]