SWE在系统性红斑狼疮患者腓肠神经受损中的应用价值  

Application of shear wave elastography in sural nerve injury in patients with systemic lupus erythematosus

作　　者：朱彩霞 袁文欣[1] 王婧玲 陈莉[1] 张卫平[1] ZHU Cai-xia;YUAN Wen-xin;WANG Jing-ling;CHEN Li;ZHANG Wei-ping(Department of Ultrasound,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院超声医学科,江西南昌330006

出　　处：《中国临床医学影像杂志》2024年第5期355-359,共5页Journal of China Clinic Medical Imaging

基　　金：江西省卫生健康委员会科技计划项目(202210452);江西省中医药管理局科技计划项目(2021A060)。

摘　　要：目的:探讨剪切波弹性成像技术(SWE)在系统性红斑狼疮(SLE)患者腓肠神经受损中的应用价值。方法:收集SLE患者72例(72根神经,选取神经受损严重侧,若相同则随机选取任意一侧),依照神经电生理检查结果是否存在腓肠神经受损分为神经受损组(A组,n=39)和非神经受损组(B组,n=33)。选取健康成人59例为对照组(C组)。所有受试者均行腓肠神经的常规超声及SWE检查,分别测得小腿后部中下1/3处腓肠神经左右径(D1)、前后径(D2)、周长(C)、横截面积(CSA)、杨氏模量最大值(Emax)、最小值(Emin)及均值(Emean),比较A、B、C三组腓肠神经各参数差异,并绘制Emax、Emin、Emean诊断SLE腓肠神经受损的受试者工作特性(ROC)曲线。结果:对照组左、右侧之间Emax、Emin、Emean值无明显统计学差异(P>0.05),故取两侧杨氏模量平均值进行组间比较;三组间Emax、Emin、Emean值差异均有统计学意义(P<0.05),且A组Emax、Emin、Emean值大于B组及C组,B组Emax、Emin、Emean值大于C组,三组间D1、D2、C及CSA值差异无统计学意义(P>0.05)。Emax、Emin、Emean诊断SLE腓肠神经受损的ROC曲线下面积分别为0.706、0.653、0.685,三者诊断效能无明显差异。结论:SWE成像可以用于SLE患者评估腓肠神经硬度,为临床上腓肠神经受损的诊断提供无创评估方法。Objective:To evaluate the value of shear wave elastography(SWE)in the diagnosis of sural nerve injury in patients with systemic lupus erythematosus(SLE).Methods:A total of 72 patients(total 72 nerves,the side with severe nerve damage was selected,if they were the same,side was randomly selected)of SLE were collected,and divided into nerve damage group(group A,n=39)and non-nerve damage group(group B,n=33)according to the results of electrophysiological examination.Fifty-nine healthy adults were selected as control group(group C).All the subjects underwent conventional ultrasound and SWE examination of the sural nerve.The left-right diameter(D1),anterior-posterior diameter(D2),circumference(C),crosssectional area(CSA),maximum Young’s modulus(Emax),minimum Young’s modulus(Emin)and mean value(Emean)of the sural nerve were measured.The parameters of sural nerve in group A,B and C were compared,and the receiver operating characteristic(ROC)curve of Emax,Emin and Emean in the diagnosis of sural nerve injury in SLE was drawn.Results:There was no significant difference in Emax,Emin and Emean between the left and right sides of the control group(P>0.05).Therefore,the average value of Young’s modulus on both sides was taken for comparison between groups.There were significant differences in Emax,Emin and Emean among the three groups(P<0.05).Emax,Emin and Emean in the group A were significantly higher than those in the other two groups,and Emax,Emin and Emean in group B were significantly higher than those in group C.But the comparison of D1,D2,C and CSA among the three groups showed no significant difference(P>0.05).The area under ROC curve of Emax,Emin and Emean in diagnosing SLE with sural nerve damage were 0.706,0.653 and 0.685 respectively,showing no significant difference in diagnostic efficacy among them.Conclusion:SWE can be used to assess sural nerve stiffness in SLE patients to provide a non-invasive evaluation method for the diagnosis of sural nerve injury.

关 键 词：红斑狼疮 系统性 腓肠神经 超声检查 

分 类 号：R593.241[医药卫生—内科学] R445.1[医药卫生—临床医学]