应用超声新技术对肱骨外上髁炎患者的伸肌总腱多模态观察  

Multimodal Observation of Extensor Common Tendon in Patients with External Humeral Epicondylitis by Using New Ultrasonic Technology

作　　者：俞成杰[1] 徐芳[1] 瞿岳[1] YU Chengjie;XU Fang;QU Yue(Department of Ultrasonography,Longhua Hospital Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院超声科,上海200032

出　　处：《中国医疗设备》2022年第11期85-89,共5页China Medical Devices

基　　金：上海中医药大学附属龙华医院爱建捐赠基金(AJ028)。

摘　　要：目的选用超声实时剪切波弹性成像(Shear Wave Elastography,SWE)和平面波超敏感血流显像(Angio Plus,AP)多模态观察肱骨外上髁炎患者伸肌总腱的弹性及血流情况,探究2种技术在肱骨外上髁炎中的临床应用价值。方法回顾性选取2019年3月至2020年3月我院收治的72例肱骨外上髁炎患者作为观察组,另选取同期95例肘关节无症状的正常志愿者作为对照组,所有受试者均行常规超声、SWE、AP检测。观察两组伸肌总腱超声特征(伸肌总腱、内部回声、血流分布、钙化、周边骨质、积液等),以及SWE剪切波速度最大值、最小值、平均值及AP血流分级情况。结果观察组伸肌总腱剪切波速度最大值、最小值、平均值均低于对照组,差异有统计学意义(P<0.05);观察组伸肌总腱1~3级血流等级占比高于对照组,差异有统计学意义(P<0.05);伸肌总腱厚度、损伤程度均与剪切波速度最大值、最小值、平均值均呈负相关(r=-0.663~-0.598,P<0.05),与血流分布等级均呈正相关(r=0.711、0.737,P<0.05)。当剪切波速度最大值、最小值、平均值分别取4.65、2.71、3.57时,预测肱骨外上髁炎发生的AUC值分别为0.836、0.864、0.887,诊断效能较高。血流分级≥2级时,预测肱骨外上髁炎发生的AUC值为0.879,诊断效能较高。结论肱骨外上髁炎患者伸肌总腱剪切波速度明显降低,血流信号明显增多,且与伸肌总腱厚度及损伤程度显著相关。SWE和AP技术可以灵敏地量化伸肌总腱的弹性及血供变化情况,可作为评估肱骨外上髁炎病变的有效辅助诊断方法。Objective To investigate the clinical value of ultrasound real-time shear wave elastography(SWE)and plane wave ultrasensitive blood flow imaging angio plus(AP)in patients with external humeral epicondylitis to observe the elasticity and blood flow of extensor tendon in multiple modes.Methods A total of 72 patients with external humeral epicondylitis who were admitted to our hospital from March 2019 to March 2020 were retrospectively enrolled as observation group.At the same time,95 normal volunteers with asymptomatic elbow joints were selected as healthy control group.All subjects underwent conventional ultrasound,SWE and AP tests.The ultrasonic characteristics of the total extensor tendon(total extensor tendon,internal echo,blood flow distribution,calcification,peripheral bone,and effusion,etc.),maximum,minimum and average SWE shear wave velocity and AP blood flow grade of the two groups were observed.Results The maximum value,minimum value and average value of shear wave velocity of total extensor tendon in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The blood flow grade 1-3 in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The thickness of extensor tendon and the degree of injury were negatively correlated with the maximum,minimum and average value of shear wave velocity(r=-0.663~-0.598,P<0.05),and positively correlated with the grade of blood flow distribution(r=0.711,0.737,P<0.05).When the maximum,minimum and average shear wave velocities were 4.65,2.71 and 3.57,respectively,the AUC values for predicting the occurrence of external humeral epicondylitis were 0.836,0.864 and 0.887,respectively,indicating a high diagnostic efficiency.When blood flow grade≥2,the AUC value of predicting the occurrence of external humeral epicondylitis was 0.879,indicating a high diagnostic efficiency.Conclusion In patients with lateral epicondylitis,the shear wave velocity of ex

关 键 词：肱骨外上髁炎 实时剪切波弹性成像 平面波超敏感血流显像 伸肌总腱 诊断价值 

分 类 号：R739[医药卫生—肿瘤] R445.1[医药卫生—临床医学]