能量多普勒超声联合剪切波弹性成像评估冈上肌肌腱损伤程度的临床价值  

Clinical value of power Doppler ultrasound combined with shear wave elastography in evaluating the degree of supraspinatus tendon injury

作　　者：林璐 张敏 曾燕红 刘志亚 LIN Lu;ZHANG Min;ZENG Yanhong;LIU Zhiya(Department of Ultrasound,Zhoushan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine,Zhejiang 316000,China)

机构地区：[1]浙江中医药大学附属舟山中医院超声科,浙江省舟山市316000

出　　处：《临床超声医学杂志》2024年第6期496-499,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨能量多普勒超声联合剪切波弹性成像评估冈上肌肌腱损伤程度的临床价值。方法选取我院收治的冈上肌肌腱损伤患者80例,应用能量多普勒超声获取肌腱血流信号评分,剪切波弹性成像获取剪切波速度(SWV);比较不同程度冈上肌肌腱损伤患者血流信号评分和SWV的差异。以关节镜探查结果为金标准,绘制受试者工作特征(ROC)曲线分析能量多普勒超声、剪切波弹性成像单独及联合应用对冈上肌肌腱撕裂(包括部分撕裂和全层撕裂)的诊断效能。结果80例冈上肌肌腱损伤患者中,关节镜探查结果显示肌腱慢性磨损者21例,部分撕裂者32例,全层撕裂者27例。慢性磨损者、部分撕裂者、全层撕裂者血流信号评分分别为(1.14±0.26)分、(1.55±0.38)分、(1.79±0.45)分,冈上肌肌腱SWV分别为(5.61±0.99)m/s、(5.05±0.98)m/s、(4.55±0.89)m/s,差异均有统计学意义(F=17.452、7.317,均P<0.05)。ROC曲线分析显示,能量多普勒超声、剪切波弹性成像单独及联合应用诊断冈上肌肌腱撕裂的灵敏度分别为67.80%、69.49%、98.31%,特异度分别为85.71%、80.95%、80.95%,准确率分别为68.75%、70.00%、90.00%,曲线下面积分别为0.760、0.735、0.896;联合应用的曲线下面积高于各方法单独应用,差异均有统计学意义(均P<0.05)。结论能量多普勒超声联合剪切波弹性成像可准确评估冈上肌肌腱损伤程度,具有较好的临床价值。Objective To explore the clinical value of power Doppler ultrasound combined with shear wave elastography in evaluating the degree of supraspinatus tendon injury.Methods A total of 80 patients with supraspinatus tendon injury confirmed in our hospital were enrolled,the blood flow signal score was obtained by power Doppler ultrasound,and the shear wave velocity(SWV)was detected by shear wave elastography.The differences of blood flow signal score and SWV in patients with different degrees of supraspinatus tendon injury were compared.Taking the results of arthroscopic exploration as the gold standard,the receiver operating characteristic(ROC)curve was drawn to analyze the value of power Doppler ultrasound,shear wave elastography alone and in combination for diagnosing supraspinatus tendon tears(including partial tears and fullthickness tears).Results Among the 80 patients with supraspinatus tendon injury,arthroscopic exploration showed that there were 21 cases of chronic tendon wear,32 cases of partial tear,and 27 cases of full-thickness tear.The blood flow signal scores of patients with chronic wear,partial tear and full-thickness tear were(1.14±0.26)points,(1.55±0.38)points and(1.79±0.45)points,respectively.The SWV of supraspinatus tendon were(5.61±0.99)m/s,(5.05±0.98)m/s and(4.55±0.89)m/s,respectively,with statistical significance(F=17.452,7.317,both P<0.05).ROC curve analysis showed that the sensitivity of power Doppler ultrasound,shear wave elastography alone and in combination for diagnosing supraspinatus tendon tears were 67.80%,69.49%and 98.31%,the specificity were 85.71%,80.95%and 80.95%,the accuracy were 68.75%,70.00%and 90.00%,and the area under the curve were 0.760,0.735 and 0.896,respectively.The area under the curve of combined application was higher than that of each method alone(both P<0.05).Conclusion Power Doppler ultrasound combined with shear wave elastography could accurately evaluate the degree of supraspinatus tendon injury,which has good clinical value.

关 键 词：超声检查 多普勒 能量 剪切波弹性成像 肌腱损伤 肌腱撕裂 冈上肌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R685[医药卫生—诊断学]