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中华医学超声杂志(电子版) ›› 2021, Vol. 18 ›› Issue (07) : 696 -700. doi: 10.3877/cma.j.issn.1672-6448.2021.07.015

肌肉骨骼超声影像学

动态超声弹性成像技术评估帕金森病肌强直程度的临床研究
李元子1, 殷露1, 何文1, 肖杨2, 周永进2, 王雨萌1, 杨静1, 黄文燕1, 张惠琴1, 马惠姿3,(), 杜丽娟1,()   
  1. 1. 100070 首都医科大学附属北京天坛医院超声科
    2. 100070 首都医科大学附属北京天坛医院神经内科
    3. 518055 中国科学院深圳先进技术研究院
  • 收稿日期:2020-03-12 出版日期:2021-07-01
  • 通信作者: 马惠姿, 杜丽娟
  • 基金资助:
    帕金森病患者肌强直程度的超声弹性成像研究(首都临床特色应用研究Z201107001012140)

Quantification of passive muscle stiffness in Parkinson's disease by dynamic shear wave elastography

Yuanzi Li1, Lu Yin1, Wen He1, Yang Xiao2, Yongjin Zhou2, Yumeng Wang1, Jing Yang1, Wenyan Huang1, Huiqin Zhang1, Huizi Ma3(), Lijuan Du1()   

  1. 1. Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
    2. Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences, Shenzhen 518055, China
    3. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
  • Received:2020-03-12 Published:2021-07-01
  • Corresponding author: Huizi Ma, Lijuan Du
引用本文:

李元子, 殷露, 何文, 肖杨, 周永进, 王雨萌, 杨静, 黄文燕, 张惠琴, 马惠姿, 杜丽娟. 动态超声弹性成像技术评估帕金森病肌强直程度的临床研究[J/OL]. 中华医学超声杂志(电子版), 2021, 18(07): 696-700.

Yuanzi Li, Lu Yin, Wen He, Yang Xiao, Yongjin Zhou, Yumeng Wang, Jing Yang, Wenyan Huang, Huiqin Zhang, Huizi Ma, Lijuan Du. Quantification of passive muscle stiffness in Parkinson's disease by dynamic shear wave elastography[J/OL]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(07): 696-700.

目的

探讨动态超声弹性成像技术评估帕金森病骨骼肌生物力学特征的价值。

方法

选取2019年1月至9月在首都医科大学附属北京天坛医院入院、明确诊断为帕金森病的患者28例作为帕金森病组,选取同期健康志愿者作为健康对照组,共10名。应用超声弹性成像技术完成2组受试者腓肠肌动态弹性检查,记录被动背屈踝关节过程中,关节角度对应的腓肠肌内侧头超声弹性模量值变化,进一步描记弹性模量-关节角度曲线。采用两独立样本t检验比较不同人群间曲线参数E0(肌肉完全松弛状态下弹性值)、松弛角(肌张力开始增高时的踝关节运动角度)及肌肉厚度和长度的差异。

结果

(1)帕金森病组弹性参数E0小于健康对照组[(10.30±2.75)kPa vs (11.64±1.26)kPa],差异具有统计学意义(t=-2.704,P=0.009);(2)帕金森病组松弛角小于健康对照组[(-27.49±5.23)° vs (-21.77±4.58)°,差异具有统计学意义(t=-4.168,P<0.001)。(3)2组间肌腹厚度与肌肉长度比较,差异均无统计学意义(P均>0.05)。

结论

动态超声弹性成像技术可用于评估帕金森病肌张力状态等生物力学特征。

Objective

To investigate the clinical value of dynamic shear wave elastography in the evaluation of muscular rigidity in Parkinson's disease.

Methods

From January to September 2019, 28 patients confirmed with Parkinson's disease and 10 healthy controls at Beijing Tiantan Hospital, Capital Medical University were recruited. Dynamic shear wave elastography was used to record the elastic modulus of the medial gastrocnemius during the ankle joint passive dorsiflexion, the curves of elastic modulus-ankle joint angles were described, and the differences of curve parameters, muscle elastic modulus in relaxation (E0), and slack angle (beyond which the muscle begins to develop passive tension) between the two groups were compared by t-test.

Results

The mean E0 in the Parkinson's disease group was significantly lower than that in the healthy control group [(10.30±2.75) kPa vs (11.64±1.26) kPa; t=-2.704, P=0.009). The slack angle in the Parkinson's disease group was significantly smaller than that of the healthy control group (-27.49±5.23)° vs (-21.77±4.58)°; t=-4.168, P<0.001). There was no significant difference in gastrocnemius muscle thickness or muscle length between the two groups (P>0.05).

Conclusion

Dynamic shear wave elastography can be used to detect the biomechanical characteristics of Parkinson's disease, such as the state of muscle rigidity.

图1 帕金森病患者踝关节被动匀速运动过程中腓肠肌内侧头超声弹性图像(患者女性,62岁,H-Y分期为2.0期)。图a示踝关节跖屈28.7°松弛角θ0处(弹性值10.9 kPa);图b示踝关节中位0°处(弹性值54.4 kPa);图c示踝关节背屈10°处(弹性值136.3 kPa)
图2 健康对照组踝关节被动匀速运动过程中腓肠肌内侧头超声弹性图像(受试者女性,61岁,健康志愿者)。图a示踝关节跖屈22.2°松弛角θ0处弹性图像(弹性值10.2 kPa);图b示踝关节中位0°处弹性图像(弹性值39.2 kPa);图c示踝关节背屈10°处弹性图像(弹性值93.6 kPa)
图3 关节角度-弹性模量曲线图。图a为帕金森病患者,图b为健康志愿者。红色点为松弛角对应坐标点,踝关节角度的负值代表跖屈,0°代表脚掌平面与胫骨呈90°时的状态,踝关节角度的正值代表背屈
表1 帕金森病组与健康对照组腓肠肌弹性参数值比较(
xˉ
±s)
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