高频超声及剪切波弹性成像定量评估产后腹直肌分离  

Quantitative evaluation of diastasis rectus abdominis by high-frequency ultrasound and shear wave elastography

作　　者：汪亮 黄俊[2] 王小娜 WANG Liang;HUANG Jun;WANG Xiaona(Department of Ultrasound,the Affiliated Guangzhou Red Cross Hospital of Ji’nan University,Guangzhou 510220,China;不详)

机构地区：[1]暨南大学附属广州市红十字会医院超声科,广州市510220 [2]暨南大学基础医学与公共卫生学院公共卫生与预防医学系

出　　处：《临床超声医学杂志》2023年第1期44-48,共5页Journal of Clinical Ultrasound in Medicine

基　　金：广州市卫生健康科技项目(20221A010017)。

摘　　要：目的应用高频超声及剪切波弹性成像(SWE)定量评估产后女性的腹直肌间距、腹直肌厚度及硬度,分析评估腹直肌分离(DRA)的相关因素。方法选取于我院门诊进行产后复查的初产妇224例,应用高频超声、SWE获得脐上3 cm、脐水平、脐下3 cm的腹直肌间距、腹直肌厚度、弹性模量值(E)及剪切波速度(V),收集产妇临床资料。以任一部位腹直肌间距>2 cm作为诊断DRA的标准,将产妇分为DRA组144例和对照组80例,比较两组上述参数的差异。采用二元Logistic回归分析各参数与DRA的关系,绘制受试者工作特征(ROC)曲线分析各参数诊断DRA的效能。结果两组年龄、孕前和产后体质量指数、分娩方式、产前腹围、新生儿体质量、腹直肌肌力、肌耐力时间及Oswestry功能障碍指数(ODI)评分比较,差异均有统计学意义(均P<0.01)。DRA组平均腹直肌厚度、E、V分别为(7.30±0.67)mm、10.85(9.67,12.13)kPa、1.85(1.73,1.97)m/s,对照组分别为(7.99±0.56)mm、13.20(12.23,14.04)kPa、2.07(1.97,2.13)m/s,两组比较差异均有统计学意义(均P<0.01)。二元Logistic回归分析显示,腹直肌厚度、E、V是评估DRA的独立相关因素。ROC曲线分析显示,当腹直肌厚度、E、V分别以7.45 mm、12.05 kPa、1.95 m/s为截断值,其诊断DRA的曲线下面积分别为0.785、0.852、0.862,且E、V的曲线下面积均大于腹直肌厚度(均P<0.05)。结论应用高频超声及SWE可定量分析腹直肌厚度和硬度,均是评估DRA的独立相关因素,且腹直肌硬度与DRA关系更密切。Objective To quantitatively evaluate the inter-rectus distance,stiffness and thickness of rectus abdominis in postpartum women by high-frequency ultrasound and shear wave elastography(SWE),and to analyze the related factors of diastasis rectus abdominis(DRA).Methods A total of 224 primiparas who underwent postpartum examination in the outpatient department of our hospital were selected.The inter-rectus distance of rectus abdominis,thickness,elastic modulus(E),and shear wave velocity(V)at 3 cm above the umbilicus,umbilicus level,and 3 cm below the umbilicus were obtained by high-frequency ultrasound and SWE.The distance of the rectus abdominis muscle>2 cm at any site was used as a criterion for the diagnosis of DRA.The women were divided into DRA group(n=144)and the control group(n=80),and the differences of the above parameters between the two groups were compared.The correlation between each ultrasonic parameter and DRA was analyzed by binary Logistic regression,and the efficacy of each parameter in diagnosing DRA was analyzed by receiver operating characteristics(ROC)curve.Results The differences of age,pre-pregnancy and postpartum body mass index,mode of delivery,prenatal abdominal circumference,neonatal body mass,rectus abdominis muscle strength,muscle endurance time and Oswestry Dysfunction Index(ODI)scores were statistically significant between two groups(all P<0.01).The mean thickness,E and V of rectus abdominis in the DRA group were(7.30±0.67)mm,10.85(9.67,12.13)kPa,and 1.85(1.73,1.97)m/s,respectively.The mean thickness,E,and V of rectus abdominis in the control group were(7.99±0.56)mm,13.20(12.23,14.04)kPa,2.07(1.97,2.13)m/s,and the differences of the above parameters between two groups were statistically significant(all P<0.01).Binary Logistic regression analysis showed that rectus abdominis thickness,E and V were independent influence factors of DRA.ROC.curve analysis showed that when the cut-off value of rectus abdominis thickness,E and V were 7.45 mm,and 12.05 kPa,1.95 m/s,respectively,their area u

关 键 词：超声检查 剪切波弹性成像 腹直肌分离 硬度 厚度 

分 类 号：R445.1[医药卫生—影像医学与核医学]