剪切波弹性成像评价糖尿病足背部拇短伸肌硬度的价值  

Evaluation of Stiffness of Extensor Pollicis Brevis Muscle of Diabetic Foot by Shear Wave Elastography

作　　者：颜富强 蔡名利 黄珊珊 陈碧雄 林金淼 黄柳清 吕国荣 Yan Fuqiang;Cai Mingli;Huang Shanshan;Chen Bixiong;Lin Jinmiao;Huang Liuqing;Lyu Guorong(Jinjiang Municipal Hospital(Shanghai Sixth People’s Hospital Fujian Campus),Quanzhou,Fujian 362000,China;Quanzhou Medical College Provincial Collaborative Innovation Center for Maternal and Infant Health Service Application Technology,Quanzhou,Fujian 362000,China)

机构地区：[1]晋江市医院(上海市第六人民医院福建医院),福建省泉州市362000 [2]泉州医学高等专科学校省级母婴健康服务技术协同创新中心,福建省泉州市362000

出　　处：《中国超声医学杂志》2023年第1期116-119,共4页Chinese Journal of Ultrasound in Medicine

基　　金：泉州科技局计划项目(No.2022NS017)。

摘　　要：目的 探讨剪切波弹性成像(SWE)评价糖尿病足背部拇短伸肌弹性改变的应用价值。方法 收集2型糖尿病(DM)组14例、2型糖尿病合并微血管病变(DM+MC)组16例及正常对照组25例。对正常组SWE测量采用组内相关系数(ICC)及Bland-Altman图进行同一医师及不同医师弹性测量的可重复性及一致性分析;利用剪切波弹性成像(SWE)测量足拇短伸肌的平均杨氏模量值(Emean),有差异则进行事后两两比较。探讨足背部拇短伸肌弹性模量值对不同严重程度糖尿病的诊断价值。结果 同一医师及不同医师SWE测量足拇短伸肌的可重复性及一致性均高,以同一医师最佳(ICC为0.863 7,95%一致性界限的上下限为-1.477SD~1.652SD);足背部拇短伸肌的Emean与糖尿病严重程度呈正相关,Emean在DM+MC组>DM组>正常组,各组间差异均有统计学意义(P<0.05);以DM+MC为诊断结果绘制受试者工作特征曲线,Emean的曲线下面积(AUC)为0.962,灵敏度为87.5%,特异度为89.7%。结论 剪切波弹性成像评价糖尿病足背部骨骼肌弹性改变具有可行性,Emean随着糖尿病程度加重而增加,在糖尿病足早期预防及诊治中具备潜在临床应用价值。Objective To investigate the application value of shear wave elastography(SWE) in evaluating the elasticity of extensor pollicis Brevis in diabetic foot.Methods Fourteen cases of type 2 diabetes mellitus(DM) group,sixteen cases of Type 2 diabetes mellitus with microangiopathy(DM+MC) group,and twenty-five cases of normal control group were collected.The repeatability and consistency of SWE measurement were analyzed by intra-group correlation coefficient(ICC) and Bland-Altman diagram for the same physician and different physicians.The average young’s Modulus(Emean) of the extensor pollicis brevis was measured by shear wave elastography(SWE).To investigate the diagnostic value of the elastic modulus of the extensor pollicis brevis muscle of the Dorsum of the foot for diabetes of different severity.Results The repeatability and consistency of the measurement of extensor hallucis brevis by SWE of the same physician and different physicians were high,and the best was the same physician(ICC was 0.8637,the upper and lower limit of 95% consistency was-1.477 SD~1.652 SD).There was a positive correlation between the Emean of the extensor pollicis brevis of the dorsum Pedis and the severity of diabetes mellitus.The Emean was in the DM+MC group>DM group>normal group,and the difference was statistically signifucant(P<0.05).The area under the curve of Emean(AUC) was 0.962,the sensitivity was 87.5%,and the specificity was 89.7%.Conclusions SWE is feasible to evaluate the changes of the dorsal skeletal muscle elasticity in the diabetic foot.Emean increases with the aggravation of diabetes,and has potential clinical application value in the early prevention and diagnosis of diabetic foot.

关 键 词：糖尿病 微循环 骨骼肌 剪切波弹性成像 

分 类 号：R445.1[医药卫生—影像医学与核医学] R587.2[医药卫生—诊断学]