超声成像在牛的跟腱末端纤维软骨中的验证及在伴有脊柱关节炎的人群中的变化描述。

Validation of ultrasound imaging for Achilles entheseal fibrocartilage in bovines and description of changes in humans with spondyloarthritis.

机构信息

Section of Musculoskeletal Diseases, The Leeds Institute of Molecular Medicine, University of Leeds and Chapel Allerton Hospital, Leeds, UK.

出版信息

Ann Rheum Dis. 2010 Dec;69(12):2165-8. doi: 10.1136/ard.2009.127175. Epub 2010 Aug 19.

DOI:10.1136/ard.2009.127175

PMID:20724310

Abstract

BACKGROUND

Entheseal fibrocartilage (EF) derangement is hypothesised to be pivotal to the pathogenesis of spondyloarthritis. Ultrasound is useful for visualisation of the enthesis but its role in EF visualisation is uncertain. This work aimed to demonstrate face and content validity of ultrasound for EF visualisation both by bovine histological evaluation and EF imaging in spondyloarthritis.

METHODS

Achilles enthesis of 18 bovine hindfeet was visualised using a MyLab 70 ultrasound machine. The presence of tissue with EF characteristics was documented and histological confirmation was performed on five randomly selected sections using Masson trichrome staining. Ultrasound of the Achilles tendon (AT) was performed in 19 patients with spondyloarthritis and 21 healthy controls (HC).

RESULTS

The bovine EF could be visualised in all cases and seen as a thin, uncompressible, well-defined, anechoic layer between the hyperechoic bone and the hyperechoic fibrils of the enthesis both in longitudinal and transverse scans. This region corresponded to EF on histological examination. The same pattern of low signal corresponding to EF location was seen in 17/19 patients and all HC. Discontinuities of the anechoic layer around the erosions and enthesophytes were observed in the spondyloarthritis group. The thickness of the anechoic layer was not significantly different in spondyloarthritis and HC (0.5 ± 0.1 vs 0.5 ± 0.2 mm, p=0.9) whereas the thickness of the EF was greater in men (0.6 ± 0.2 vs 0.5 ± 0.1 mm; p=0.009) compared with women.

CONCLUSION

Ultrasound can visualise EF of the AT insertion, which can be abnormal in cases of spondyloarthritis. This has implications for a better understanding of enthesopathy.

摘要

背景

腱骨纤维软骨（EF）紊乱被认为是脊柱关节炎发病机制的关键。超声对于腱止点的可视化是有用的，但它在 EF 可视化中的作用尚不确定。本研究旨在通过牛组织学评估和脊柱关节炎 EF 成像来证明超声在 EF 可视化方面的表面和内容效度。

方法

使用 MyLab 70 超声仪对 18 只牛后脚的跟腱止点进行可视化。记录具有 EF 特征的组织的存在情况，并对随机选择的 5 个部分进行 Masson 三色染色的组织学确认。对 19 例脊柱关节炎患者和 21 例健康对照者（HC）进行跟腱超声检查。

结果

在所有情况下均能观察到牛 EF，在纵向和横向扫描中，EF 可被视为在骨的高回声和腱止点的高回声纤维之间的薄的、不可压缩的、定义明确的、无回声层。该区域与组织学检查中的 EF 相对应。在 17/19 例患者和所有 HC 中，都可以看到与 EF 位置相对应的低信号相同的模式。在脊柱关节炎组中，在侵蚀和腱骨赘周围观察到无回声层的不连续。 EF 厚度在脊柱关节炎和 HC 之间无显著差异（0.5±0.1 与 0.5±0.2mm，p=0.9），而男性的 EF 厚度大于女性（0.6±0.2 与 0.5±0.1mm；p=0.009）。