Zhang Cici, Duan Lixia, Liu Qiong, Zhang Wen
Department of Radiology, Guangzhou Red Cross Hospital, Medical College, Jinan University, Guangzhou, China.
Exercise Rehabilitation Department, Ersha Sports Training Center Hospital of Guangdong Province, No. 28, Da-tong Road, Ersha, Yue-xiu District, Guangzhou, 510105, Guangdong, China.
J Med Ultrason (2001). 2020 Jul;47(3):469-476. doi: 10.1007/s10396-019-00979-7. Epub 2019 Nov 21.
The purpose of this study was to investigate changes in morphological and elastic properties, as estimated by B-mode ultrasound (B-US) and shear wave elastography (SWE), in volleyball athletes with patellar tendinopathy (PT) and changes after extracorporeal shockwave therapy (ESWT) as well as their relationships with US measurements and Victorian Institute of Sport Assessment-Patella (VISA-P) scores in PT.
Twelve healthy athletes (24 patellar tendons) and 31 volleyball athletes with PT (48 tendons) were included. All were examined by US and received VISA-P scores before the start of the study. The athletes received 3 months of ESWT and underwent US and VISA-P at 1 month and 3 months. VISA-P scores were used to evaluate therapeutic efficacy. Tendon thickness and cross-sectional area (CSA) were detected by B-US, and the elastic modulus was measured by SWE. Correlations between VISA-P and US measurements were calculated.
Thickness, CSA, and elastic modulus of the patellar tendon in PT were higher than those in healthy athletes (P < 0.000). In PT with ESWT, VISA-P scores decreased by 22.1% (P < 0.000) and thickness decreased by 11.2% relative to baseline (P < 0.000). CSA decreased by 1.4% (P < 0.000). The elastic modulus decreased by 15.2% (P < 0.000). Elastic modulus, thickness, and CSA had significant negative correlations with VISA-P scores (P ≤ 0.005), with a stronger correlation between elastic modulus and VISA-P.
Athletes with PT had stiffer and larger tendons than healthy athletes. SWE combined with B-US could clearly show the changes in tendon thickness, CSA, stiffness in PT, and changes after treatment. SWE combined with B-US provided visualization with quantitative, reproducible, and noninvasive imaging in the follow-up evaluation of PT and is worth promoting clinically.
本研究旨在通过B型超声（B-US）和剪切波弹性成像（SWE）评估髌腱病（PT）排球运动员的形态学和弹性特性变化、体外冲击波疗法（ESWT）后的变化，以及它们与PT中超声测量值和维多利亚运动评估髌骨量表（VISA-P）评分的关系。
纳入12名健康运动员（24条髌腱）和31名患有PT的排球运动员（48条髌腱）。在研究开始前，所有受试者均接受超声检查并获得VISA-P评分。运动员接受3个月的ESWT治疗，并在1个月和3个月时接受超声检查和VISA-P评估。VISA-P评分用于评估治疗效果。通过B-US检测肌腱厚度和横截面积（CSA），并通过SWE测量弹性模量。计算VISA-P与超声测量值之间的相关性。
PT患者髌腱的厚度、CSA和弹性模量高于健康运动员（P < 0.000）。在接受ESWT治疗的PT患者中，VISA-P评分相对于基线下降了22.1%（P < 0.000），厚度下降了11.2%（P < 0.000）。CSA下降了1.4%（P < 0.000）。弹性模量下降了15.2%（P < 0.000）。弹性模量、厚度和CSA与VISA-P评分呈显著负相关（P≤0.005），弹性模量与VISA-P之间的相关性更强。
患有PT的运动员比健康运动员的肌腱更硬、更大。SWE联合B-US能够清晰显示PT患者肌腱厚度、CSA、硬度的变化以及治疗后的变化。SWE联合B-US在PT的随访评估中提供了定量、可重复且无创的可视化成像，值得临床推广。
