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超声剪切波弹性成像评估帕金森病患者肌肉僵硬程度的初步观察

Ultrasound shear wave elastography in assessment of muscle stiffness in patients with Parkinson's disease: a primary observation.

作者信息

Du Li-Juan, He Wen, Cheng Ling-Gang, Li Shuo, Pan Yue-Song, Gao Jing

机构信息

Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

出版信息

Clin Imaging. 2016 Nov-Dec;40(6):1075-1080. doi: 10.1016/j.clinimag.2016.05.008. Epub 2016 May 29.

Abstract

OBJECTIVE

The aim of this study was to assess the capability of ultrasound shear wave elastography (SWE) in evaluating the muscle stiffness in patients with Parkinson's diseases (PD).

METHODS

Ultrasound SWE of the longitudinal biceps brachii was performed on 46 patients with PD and 31 healthy controls from May 2013 to October 2013. The stiffness of the biceps brachii muscles measured with quantitative Young's modulus (kPa) was compared between the remarkably symptomatic arms and mildly symptomatic arms in the PD and between PD and controls with unpaired t test. The correlation between the Young's modulus of the biceps brachii measured by SWE and motion scores assessed by unified Parkinson's disease rating scale (UPDRS) part III was analyzed by Pearson's correlation coefficient. The reliability of SWE in assessment of biceps brachii stiffness was tested using intraclass correlation coefficient (ICC).

RESULTS

The mean Young's modulus of biceps brachii in remarkably symptomatic arms, mildly symptomatic arms, and healthy controls was 59.94±20.91 kPa, 47.77±24.00 kPa, and 24.28±5.09 kPa, respectively. A significant difference in Young's modulus of biceps brachii was found between healthy controls and all PD patients (all P<.05); however, it was not between remarkably symptomatic and mildly symptomatic arms. A positive linear correlation was found between the Young's modulus of the biceps brachii and the motion score by UPDRS in patients with PD (r=0.646, P=.000). The ICC for interobserver and intraobserver variation in measuring Young's modulus of the biceps brachii with SWE was 0.74 (95% confidence interval 0.68-0.78) and 0.78 (95% confidence interval 0.75-0.82), respectively.

CONCLUSIONS

SWE of the biceps brachii can be used as a quantitative assessment of muscle stiffness in the patients with PD.

摘要

目的

本研究旨在评估超声剪切波弹性成像(SWE)评估帕金森病(PD)患者肌肉僵硬程度的能力。

方法

2013年5月至2013年10月,对46例PD患者和31名健康对照者进行肱二头肌长轴的超声SWE检查。采用非配对t检验比较PD患者中症状明显侧上肢和症状较轻侧上肢肱二头肌的硬度(用定量杨氏模量(kPa)测量),以及PD患者与对照组之间的差异。通过Pearson相关系数分析SWE测量的肱二头肌杨氏模量与统一帕金森病评定量表(UPDRS)第三部分评估的运动评分之间的相关性。使用组内相关系数(ICC)测试SWE评估肱二头肌硬度的可靠性。

结果

症状明显侧上肢、症状较轻侧上肢和健康对照者肱二头肌的平均杨氏模量分别为59.94±20.91 kPa、47.77±24.00 kPa和24.28±5.09 kPa。健康对照者与所有PD患者之间肱二头肌杨氏模量存在显著差异(所有P<0.05);然而,症状明显侧与症状较轻侧上肢之间无差异。PD患者肱二头肌杨氏模量与UPDRS运动评分之间存在正线性相关(r=0.646,P=0.000)。SWE测量肱二头肌杨氏模量时,观察者间和观察者内变异的ICC分别为0.74(95%置信区间0.68 - 0.78)和0.78(95%置信区间0.75 - 0.82)。

结论

肱二头肌的SWE可用于定量评估PD患者的肌肉僵硬程度。

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