超声剪切波弹性成像在脑卒中患者小腿康复评定中的应用

doi:10.3969/j.issn.1006-9771.2020.07.003

《中国康复理论与实践》 ›› 2020, Vol. 26 ›› Issue (7): 753-756.doi: 10.3969/j.issn.1006-9771.2020.07.003

超声剪切波弹性成像在脑卒中患者小腿康复评定中的应用

郭忆^1a,李雪梅^1a(),张皓^1b,芦海涛^1b,冯冰^1a,王艺铮^1b

1.中国康复研究中心北京博爱医院,a. 超声科; b. 神经内科,北京市 100068

收稿日期:2020-03-20 修回日期:2020-04-30 出版日期:2020-07-25 发布日期:2020-07-24
通讯作者: 李雪梅 E-mail:18600598941@163.com
作者简介:郭忆(1974-),女,汉族,浙江杭州市人,硕士,主治医师,主要研究方向：肌骨超声、超声心动图。|李雪梅(1965-),女,汉族,四川德阳市人,主任医师,硕士,主要研究方向：肌骨超声、腹部超声。
基金资助:
中国康复研究中心课题(2018ZX-19)

Application of Ultrasound Shear Wave Elastography in Rehabilitaion Assessment of Triceps Surae and Achilles Tendon after Stroke

GUO Yi^1a,LI Xue-mei^1a(),ZHANG Hao^1b,LU Hai-tao^1b,FENG Bing^1a,WANG Yi-zheng^1b

1. a. Department of Ultrasonography; b. Department of Neurology, Beijing Bo’ai Hospital, China Rehabilitation Research Center, Beijing 100068, China

Received:2020-03-20 Revised:2020-04-30 Published:2020-07-25 Online:2020-07-24
Contact: LI Xue-mei E-mail:18600598941@163.com
Supported by:
China Rehabilitation Research Center Project(2018ZX-19)

摘要/Abstract

摘要：

目的探讨超声剪切波弹性成像对脑卒中下肢运动障碍患者小腿三头肌和跟腱进行康复评定的价值。方法 2018年至2019年,脑卒中后单侧下肢运动障碍住院患者32例,于康复治疗前后,对患者双侧小腿三头肌和跟腱行超声二维测量和剪切波弹性成像检查,记录剪切波速度(SWV)以及跟腱(比目鱼肌肌腱)长度和厚度。结果治疗前,患侧跟腱和小腿三头肌SWV较健侧增高(t > 2.426, P < 0.05);患侧跟腱长度较健侧显著增加( t = 11.801, P < 0.001);治疗后,患侧小腿三头肌SWV减低( t > 2.447, P < 0.05);患侧跟腱长度显著缩短( t = 8.577, P < 0.001)。结论康复治疗可降低脑卒中下肢运动障碍患者小腿三头肌肌张力。超声剪切波弹性成像可用于评价跟腱和小腿三头肌弹性特征,指导脑卒中康复。

关键词: 脑卒中, 剪切波弹性成像, 跟腱, 小腿三头肌, 康复评定, 肌张力

Abstract:

Objective To apply the ultrasonic shear wave elastography to evaluate triceps surae and Achilles tendon for patients with lower extremity dyskinesia after stroke. Methods Thirty-two inpatients during 2018 and 2019 with unilateral lower extremity dyskinesia after stroke were studied with 2-D ultrasound and shear wave elastography on the bilateral triceps surae and Achilles tendons before and after rehabilitation. Shear wave velocity (SWV) of the triceps surae and the Achilles tendons, the length and thickness of Achilles tendon (soleus tendon) were measured. Results Before rehabilitation, the SWV of the Achilles tendons and the triceps surae increased more in the affected side than in the unaffected side (t > 2.426, P < 0.05), as well as the length of the Achilles tendons ( t = 11.801, P < 0.001). After rehabilitation, the SWV of the triceps surae decreased ( t > 2.447, P < 0.05), as well as the length of the Achilles tendons ( t = 8.577, P < 0.001). Conclusion Ultrasound shear wave elastography can be used to evaluate the elastic characteristics of the Achilles tendon and the triceps surae, to guide the rehabilitation for stroke patients.

Key words: stroke, shear wave ultrasound elastography, Achilles tendon, triceps surae, rehabilitation assessment, muscular tension

中图分类号:

R743.3

郭忆,李雪梅,张皓,芦海涛,冯冰,王艺铮. 超声剪切波弹性成像在脑卒中患者小腿康复评定中的应用[J]. 《中国康复理论与实践》, 2020, 26(7): 753-756.

GUO Yi,LI Xue-mei,ZHANG Hao,LU Hai-tao,FENG Bing,WANG Yi-zheng. Application of Ultrasound Shear Wave Elastography in Rehabilitaion Assessment of Triceps Surae and Achilles Tendon after Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(7): 753-756.

图/表 2

参考文献 31

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组别	腓肠肌内侧头	腓肠肌外侧头	比目鱼肌
健侧	1.90±0.22	1.83±0.20	1.83±0.29
患侧治疗前	2.20±0.49	2.05±0.48	1.97±0.48
患侧治疗后	2.10±0.44	1.91±0.30	1.90±0.40
t_a值	3.911	2.940	2.426
P_a值	< 0.001	0.006	0.021
t_b值	2.447	3.143	2.487
P_b值	0.020	0.004	0.018
t_c值	2.977	1.332	1.422
P_c值	0.006	0.193	0.164

组别	长度(cm)	厚度(cm)	SWV (m/s)
健侧	7.98±1.89	0.48±0.04	7.73±1.06
患侧治疗前	9.43±2.32	0.48±0.06	8.17±0.92
患侧治疗后	8.66±2.02	0.47±0.06	8.06±0.82
t_a值	11.801	0.418	2.810
P_a值	< 0.001	0.679	0.009
t_b值	8.577	1.341	2.012
P_b值	< 0.001	0.190	0.053
t_c值	7.726	0.319	2.187
P_c值	< 0.001	0.752	0.036

超声剪切波弹性成像在脑卒中患者小腿康复评定中的应用

Application of Ultrasound Shear Wave Elastography in Rehabilitaion Assessment of Triceps Surae and Achilles Tendon after Stroke

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