Kısmalı Erkan, Göde Sercan, Turhal Göksel, Öztürk Kerem, Rașit Midilli
Departments of Radiology (E.K.) and Otolaryngology (S.G., G.T., K.Ö., R.M.), Ege University Medical School, Izmir, Turkey.
Departments of Radiology (E.K.) and Otolaryngology (S.G., G.T., K.Ö., R.M.), Ege University Medical School, Izmir, Turkey
J Ultrasound Med. 2015 May;34(5):777-82. doi: 10.7863/ultra.34.5.777.
There are diseases that affect the stroma of the inferior turbinate and many surgical interventions that alter it. However, an objective method that can evaluate the turbinate's stromal structure in detail has not been defined yet. The primary aim of this study was to investigate the effectiveness and reliability of ultrasound elastography for objective evaluation of the inferior turbinate stroma and define the most suitable elastographic technique.
Twenty inferior turbinates in 10 healthy participants were included. Five of the participants (50%) were male, and 5 (50%) were female, with a mean age ± SD of 28.3 ± 3.2 years (range, 26-35) years. To obtain reliable and reproducible results, elastography was performed twice, 3 days apart, with and without a topical decongestant to evaluate the effects of the nasal cycle and mucosal edema. Two previously described valid elastographic outcome measures were reevaluated for the inferior turbinate. The tissue strain ratio and sound wave propagation speed were calculated for each measurement.
Median propagation speeds without and with the decongestant for the first and second measurements were 2.125 (interquartile range [IQR], 0.85), 2.175 (IQR, 0.53), 2.520 (IQR, 0.79), and 2.555 (IQR, 0.53) m/s, respectively. Median turbinate stroma-to-subcutaneous tissue strain ratios without and with the decongestant for the first and second measurements were 1.402 (IQR, 0.96), 0.942 (IQR, 0.24), 1.035 (IQR, 0.98), and 1.427 (IQR, 1.68).
We suggest that elastography is a reliable and reproducible method that is not substantially affected by mucosal edema. It is a novel technique that can evaluate the inferior turbinate stroma and might be used in concordance with other objective functional techniques such as acoustic rhinometry. Therefore, it can be used in further studies regarding diagnosis of turbinate diseases and objective evaluation of previous surgical treatments.
存在影响下鼻甲基质的疾病以及许多改变下鼻甲基质的外科手术干预。然而，尚未定义一种能够详细评估鼻甲基质结构的客观方法。本研究的主要目的是探讨超声弹性成像用于客观评估下鼻甲基质的有效性和可靠性，并确定最合适的弹性成像技术。
纳入10名健康参与者的20个下鼻甲。其中5名参与者（50%）为男性，5名（50%）为女性，平均年龄±标准差为28.3±3.2岁（范围26 - 35岁）。为获得可靠且可重复的结果，弹性成像在间隔3天的情况下分别在使用和不使用局部减充血剂的状态下进行两次，以评估鼻周期和黏膜水肿的影响。针对下鼻甲重新评估了两种先前描述的有效的弹性成像结果测量指标。每次测量均计算组织应变率和声波传播速度。
第一次和第二次测量在不使用减充血剂和使用减充血剂时的传播速度中位数分别为2.125（四分位间距[IQR]，0.85）、2.175（IQR，0.53）、2.520（IQR，0.79）和2.555（IQR，0.53）m/s。第一次和第二次测量在不使用减充血剂和使用减充血剂时的鼻甲基质与皮下组织应变率中位数分别为1.402（IQR，0.96）、0.942（IQR，0.24）、1.035（IQR，0.98）和1.427（IQR，1.68）。
我们认为弹性成像是一种可靠且可重复的方法，基本不受黏膜水肿影响。它是一种能够评估下鼻甲基质的新技术，可与其他客观功能技术如鼻声反射测量法协同使用。因此，它可用于有关鼻甲疾病诊断及既往手术治疗客观评估的进一步研究。
