摘要
目的研究肌骨超声联合剪切波弹性成像(SWE)在单侧跟腱完全断裂修复术后临床监测中的应用价值。资料与方法前瞻性收集2019年9月—2020年8月于河北北方学院附属第一医院行单侧跟腱断裂修复术患者80例,分别于术后4周、8周、12周、24周、48周行双侧跟腱肌骨超声联合SWE检查。测量并比较患侧跟腱缝合端最厚处及健侧同一水平处的厚度、横截面积和杨氏模量值,并记录患侧美国足踝外科协会(AOFAS)踝-后足功能评分,分析其与上述指标的相关性。结果(1)术后4周、8周、12周、24周、48周患侧与健侧跟腱厚度(t=50.60、56.03、59.62、37.78、16.89,P均<0.05)、横截面积(t=64.10、77.73、72.71、32.70、20.64,P均<0.05)、杨氏模量值(t=19.73、26.54、37.52、54.52、66.37,P均<0.05)差异均有统计学意义;(2)术后4周、8周、12周、24周患侧跟腱厚度比较,差异有统计学意义(F=21.32,P<0.05);术后24周、48周患侧跟腱厚度比较,差异无统计学意义(t=1.54,P=0.063);术后4周、8周、12周、24周、48周患侧跟腱横截面积差异无统计学意义(F=3.01,P>0.05),杨氏模量值差异有统计学意义(F=42.18,P<0.05)。(3)术后12周、24周、48周跟腱厚度与AOFAS评分呈负相关(r=-0.221,P=0.048;r=-0.251,P=0.026;r=-0.283,P=0.011)、杨氏模量值与AOFAS评分呈正相关(r=0.324,P=0.003;r=0.406,P=0.014;r=0.432,P=0.028)。结论肌骨超声联合SWE可以动态监测跟腱断裂修复术后患者不同恢复时期的声像图变化,并指导患者康复训练,为预后提供理论基础。
Purpose To study the application value of musculoskeletal ultrasound combined with shear wave elastography(SWE)in clinical monitoring of patients with unilateral Achilles tendon complete rupture.Materials and Methods Eighty patients who underwent unilateral repair of achilles tendon rupture in the First Affiliated Hospital of Hebei North University from September 2019 to August 2020were prospectively collected.Bilateral musculoskeletal ultrasound combined with SWE was performed at 4,8,12,24 and 48 weeks postoperatively.The thickness,cross-sectional area and Young’s modulus at the thickest suture end of the achilles tendon on the affected side and at the same level of the healthy side were measured and compared,and the American association for foot and ankle surgery(AOFAS)ankle-posterior foot function score on the affected side was recorded to analyze its correlations with the above indexes.Results(1)There were statistically significant differences in thickness(t=50.60,56.03,59.62,37.78,16.89,P<0.05),cross-sectional area(t=64.10,77.73,72.71,32.70,20.64,P<0.05)and Young’s modulus(t=19.73,26.54,37.52,54.52,66.37,P<0.05)between the affected side and the healthy side at 4,8,12,24 and 48 weeks postoperatively.(2)There were statistically significant differences in the thickness of the affected achilles tendon at 4,8,12 and 24 weeks after surgery(F=21.32,P<0.05),but there were no statistically significant differences in the thickness of the affected achilles tendon at 24 and 48 weeks after surgery(t=1.54,P=0.063),and there were no statistically significant differences in the affected achilles tendon cross-sectional area at 4,8,12,24 and 48 weeks after surgery(F=3.01,P>0.05),while there were statistically significant differences in Young’s modulus(F=42.18,P<0.05).(3)There was a negative correlation between achilles tendon thickness and AOFAS score at 12,24 and 48 weeks after surgery(r=-0.221,P=0.048;r=-0.251,P=0.026;r=-0.283,P=0.011),and a positive correlation between Young’s modulus and AOFAS score(r=0.324,P=0.003;r=0.406,P=0.014;r=0.432,P=0.028).Conclusion Musculoskeletal ultrasound combined with SWE technology can be used to monitor the sonographic changes of patients in different recovery periods after repair of achilles tendon rupture,guide the rehabilitation training of patients,and provide a theoretical basis for prognosis.
作者
胡敏霞
温德惠
王立坤
徐大奎
张培楠
HU Minxia;WEN Dehui;WANG Likun;XU Dakui;ZHANG Peinan(Department of Ultrasonic Medicine,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2022年第11期1154-1158,共5页
Chinese Journal of Medical Imaging
基金
河北省省级科技计划资助(20477701D)。
关键词
跟腱断裂
术后康复
肌骨超声
剪切波弹性成像
Achilles tendon rupture
Postoperative rehabilitation
Musculoskeletal ultrasound
Shear wave elastography
