跟腱断裂手术修复后超声剪切波弹性成像评估  

Evaluation of Elastography of Torn Achilles Tendon after Surgical Repair Using Shear Wave Elastography

作　　者：陈香梅[1] 王润 袁树芳[1] 白露[2] 刘俐[1] CHEN Xiang-mei;WANG Run;YUAN Shu-fang;BAI Lu;LIU Li(Department of Ultrasound,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong Province,China;Department of Sports Medicine,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong Province,China)

机构地区：[1]北京大学深圳医院超声影像科,广东深圳518036 [2]北京大学深圳医院运动医学与康复科,广东深圳518036

出　　处：《罕少疾病杂志》2023年第3期69-71,共3页Journal of Rare and Uncommon Diseases

基　　金：深圳市卫生计生系统科研项目(SZXJ2018083);深圳市医学重点学科建设经费资助(No.SZXK051)。

摘　　要：目的应用剪切波弹性成像(shear wave elastography,SWE)技术研究跟腱断裂及手术修复后不同时间段、不同体位下的弹性变化,及其与临床功能的相关性,评价SWE成像对跟腱断裂手术修复后的评估价值。方法使用SWE成像前瞻性研究2018年1月至2019年12月因跟腱断裂在北京大学深圳医院进行手术修复的36名患者的跟腱SWE。于初次就诊时、术后3个月、6个月、12个月时分别测量跟腱中立位、最大跖屈位、最大背屈位的SWE值,同时进行Leppilahti跟腱修复评分。结果跟腱断裂后,SWE值明显下降。手术修复后,跟腱肿胀增粗,中立位长轴跟腱SWE值先增加后降低,最大背屈位长轴SWE值逐渐增加,低于健康志愿者的跟腱SWE值。中立位及最大背屈位SWE值与Leppilahti跟腱修复评分呈正相关(r=0.759,r=0.944)。结论跟腱断裂手术修复后,中立位及背屈位长轴SWE值逐渐上升,与Leppilahti跟腱修复评分呈正相关,可用于跟腱断裂术后随访。Objective To evaluate the biomechanical properties of torn Achilles tendon after surgical repair with shear wave elasticity(SWE),and its correlation with clinical function.Methods Thirty-six patients who underwent surgical treatment after complete rupture of the Achilles tendon between January 2018 and December 2019 were included.The data for the patient group were assessed before surgery,3 months,6 months and 12 months after surgery.All patients were evaluated by the Leppilahti scoring scale.The thickness and SWE values in different positions(plantar flexion,neutral position,and maximal dorsal flexion)were compared.Results Repaired Achilles tendon is physiologically larger than a healthy one.The SWE values decreased significantly in torn Achilles tendon.After surgery,the SWE values of Achilles tendon in neutral position increased firstly and then decreased.The SWE values of Achilles tendon in maximum dorsiflexion position increased over time,but were still lower than that of healthy volunteers.The SWE values of shear wave in neutral position and maximum dorsiflexion position were positively correlated with Leppilahti score(r=0.759,r=0.944).Conclusion SWE can provide biomechanical information of healing Achilles tendon after surgical repair and can be used for tracking outcomes and monitoring treatments of Achilles tendon rupture.

关 键 词：跟腱断裂 手术 超声 剪切波弹性成像 

分 类 号：R444.5[医药卫生—诊断学]