实时剪切波弹性成像评估强直型帕金森病患者早期上肢肌肉硬度的变化  

Real-Time Shear Wave Elastography in Evaluating the Changes of Muscle Stiffness of Upper Limb in Patients with Early Rigidity-Dominant Parkinson’s Disease

作　　者：丁常伟 张迎春[1] 宋馨 张英[1] 王才善[1] 刘春风[2] DING Changwei;ZHANG Yingchun;SONG Xin;ZHANG Ying;WANG Caishan;LIU Chunfeng(Department of Ultrasound,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China;不详)

机构地区：[1]苏州大学附属第二医院超声中心,江苏苏州215004 [2]苏州大学附属第二医院神经内科,江苏苏州215004

出　　处：《中国医学影像学杂志》2021年第8期826-830,共5页Chinese Journal of Medical Imaging

基　　金：苏州大学附属第二医院国家自然科学基金预研项目(SDFEYGJ1709);苏州大学附属第二医院学科建设托举工程(XKTJ-TD202007);江苏省卫生和计划生育委员会,预防医学课题(Y2018105)。

摘　　要：目的采用实时剪切波弹性成像(SWE)探索早期仅单侧发病的强直型帕金森病(PD)患者双侧上肢肌肉硬度的变化。资料与方法前瞻性选取25例早期仅单侧出现强直症状的PD患者,纳入同期25名健康志愿者作为对照组。采用SWE检测PD组及对照组肱二头肌、肱桡肌剪切波速度(SWV),并进行组间比较,分析SWV值与年龄、病程的相关性。结果对照组中,男性肱桡肌及肱二头肌SWV值[2.88(2.64~3.25)m/s比2.97(2.62~3.30)m/s]与女性[2.85(2.75~3.15)m/s比3.15(2.85~3.40)m/s]比较,差异无统计学意义(Z=-0.383、-0.817,P>0.05),且肱桡肌及肱二头肌SWV值均与年龄无相关性(r=-0.135、0.336,P>0.05)。早期强直型PD患者非强直侧肱二头肌及肱桡肌SWV值[3.57(3.25~3.90)m/s、3.26(3.10~3.45)m/s]均高于对照组[3.04(2.75~3.40)m/s、2.86(2.75~3.20)m/s,P<0.05];但低于其强直侧[4.22(3.55~5.05)m/s、3.46(3.30~3.70)m/s,P<0.05]。PD组强直侧与非强直侧肱二头肌及强直侧肱桡肌SWV值均与病程呈正相关(r=0.615、0.526、0.487,P<0.05)。结论应用SWE可以发现早期强直型PD患者的上肢肌肉硬度增加,从而有助于评估早期PD的病情。Purpose To explore the characteristics of stiffness changes of bilateral upper limb muscle in patients with early unilateral rigidity Parkinson’s disease(PD)via real-time shear wave elastography(SWE)technology.Materials and Methods A total of 25 early PD patients with only unilateral tonic symptoms were prospectively selected,and 25 healthy volunteers as the control group were enrolled during the same period.The shear wave propagation velocity(SWV)of the biceps brachii(BB)and brachioradialis(BR)were compared between the PD group and the control group via SWE,and the correlation between the SWV value and the age and the course of disease were further analyzed.Results In the control group,there were no statistical difference of the two gruop muscle SWV between male[2.88(2.64-3.25)m/s vs.2.97(2.62-3.30)m/s]and female[2.85(2.75-3.15)m/s vs.3.15(2.85-3.40)m/s;Z=-0.383 and-0.817,P>0.05],and there were no significant correlations between BB-SWV as well as BR-SWV and age(r=-0.135 and 0.336,P>0.05).BB-SWV and BR-SWV of no rigidity side group[3.57(3.25-3.90)m/s,3.26(3.10-3.45)m/s]were significantly higher than those of control group[3.04(2.75-3.40)m/s,2.86(2.75-3.20)m/s,P<0.05],but were significantly lower than those of rigid side group[4.22(3.55-5.05)m/s,3.46(3.30-3.70)m/s,P<0.05].In PD group,BBSWV on the both side and BR-SWV on the rigid side were presented significantly positive associations between the course of disease(r=0.615,0.526 and 0.487,P<0.05).Conclusion The increased stiffness of the non-rigid side muscles in patients with early rigidity-dominant PD could be detected via SWE technology,which is helpful for clinical evaluation.

关 键 词：帕金森病 超声检查 弹性成像技术 肌肉硬度 肌强直 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]