剪切波弹性成像测量冻结肩患者喙肱韧带硬度的可重复性研究  

Study on reproducibility of shear wave elastography for assessing the stiffness of coracohumeral ligament in patients with frozen shoulder

作　　者：张景锋 万艳萍 王文娟 范友谊 颜艳妮 ZHANG Jingfeng;WAN Yanping;WANG Wenjuan;FAN Youyi;YAN Yanni(Department of Ultrasound Medicine,Baoji High-Tech Hospital,Shaanxi 721003,China)

机构地区：[1]宝鸡高新医院超声医学科,陕西省宝鸡市721003

出　　处：《临床超声医学杂志》2024年第10期840-845,共6页Journal of Clinical Ultrasound in Medicine

基　　金：宝鸡市卫生健康委员会2023年科研计划立项课题(2023-053)。

摘　　要：目的探讨剪切波弹性成像(SWE)测量冻结肩患者不同肩关节外旋位置喙肱韧带硬度的可重复性。方法由两名检查者分别对45例冻结肩Ⅱ、Ⅲ期患者进行SWE检查,均采用肩关节中立位、外旋10°、外旋20°、外旋30°4种外旋位置测量喙肱韧带平均弹性模量值为喙肱韧带硬度,并于1周后进行第2次测量。采用组内相关系数(ICC)的双向随机模型分析不同肩关节外旋位置测量的喙肱韧带硬度在检查者内及检查者间的可重复性;绘制Bland-Altman图评价检查者内及检查者间测量结果的一致性。结果当采用肩关节中立位、外旋10°、外旋20°时,检查者内及检查者间测量的喙肱韧带硬度比较差异均有统计学意义(均P<0.05),检查者内及检查者间测值的可重复性均差(均ICC<0.40,均P<0.05);当采用肩关节外旋30°时,检查者内及检查者间测量的喙肱韧带硬度比较差异均无统计学意义,检查者内及检查者间测值的可重复性均好(均ICC>0.40,均P<0.001)。Shapiro-Wilk检验显示,肩关节外旋30°时检查者内及检查者间测量的喙肱韧带硬度差值均服从正态分布;Bland-Altman图显示,肩关节外旋30°时检查者内及检查者间测量的喙肱韧带硬度一致性均较好。结论应用SWE测量冻结肩Ⅱ、Ⅲ期患者喙肱韧带硬度时,采用肩关节外旋30°测量的检查者内及检查者间可重复性和一致性均较好。Objective To assess the reproducibility of shear wave elastography(SWE)in measuring the stiffness of the coracohumeral ligament in patients with frozen shoulder at different shoulder external rotation positions.Methods SWE was conducted by two examiners on 45 patients with stages Ⅱand Ⅲ frozen shoulder to measure the mean elastic modulus of the coracohumeral ligament as the ligament’s stiffness.A follow-up measurement was conducted one week later.The evaluations were carried out at four distinct external rotation positions:neutral shoulder position,and external rotations of 10°,20°,and 30°.Intra-and interexaminer reproducibility of the coracohumeral ligament’s elasticity modulus at different shoulder external rotation positions was assessed by a two-way randomized model with an intraclass correlation coefficient(ICC).Bland-Altman plots were drawn to assess the consistency of the measurement results within and between observers.Results A statistically significant differences in coracohumeral ligament stiffness were found within and between examiners in the neutral position,10°and 20°of external rotation(all P<0.05),and the reproducibility of the measured values within and between examiners was poor(all ICC<0.40,all P<0.05).At 30°rotated of external rotation,the differences in coracohumeral ligament stiffness measured within and between the examiner were not statistically significant,and the intra-examiner and inter-examiner reproducibility were both good(both ICC>0.40,both P<0.001).Shapiro-Wilk test indicated that the differences in the measurements of the coracohumeral ligament stiffness with and between the examiner followed a normal distribution at 30°of external rotation.The Bland-Altman scatter showed that at 30°of external rotation,the consistency of the measured stiffness of the coracobrachial ligament was good with and between the examiner.Conclusion The SWE measures stiffness of the coracohumerale ligament in patients with stage Ⅱ and Ⅲ frozen shoulder at 30°of external rotation of th

关 键 词：剪切波弹性成像 喙肱韧带 冻结肩 可重复性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R686[医药卫生—诊断学]