Mutlu Samet, Erdem Toslak Iclal, Inci Ayca, Cekic Bulent, Yavuz Alpaslan
Department of Radiology, University of Health Sciences Bagcilar Training and Research Hospital, Istanbul, Turkey.
Department of Radiology, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey.
J Ultrasound Med. 2021 Apr;40(4):771-778. doi: 10.1002/jum.15453. Epub 2020 Aug 28.
To investigate the B-mode ultrasound (US) features and elasticity of the Achilles tendon in patients with chronic kidney disease (CKD) using US elastography and to compare them with those of healthy individuals.
From March 2019 through May 2019, 30 consecutive patients with variable stages of CKD and 30 healthy individuals were prospectively included in this study. Ultrasound and strain elastographic examinations were performed on both Achilles tendons of all individuals. Degrees of tendinopathy, if existed, were classified as defined by Archambault et al (J Clin Ultrasound 1998; 26:335-339), and thicknesses were documented with US. Strain ratios (SRs) were calculated by measuring the strain values from the Achilles tendon and Kager fat pad. Statistical differences in the SRs of Achilles tendons between the control group and patients with CKD were calculated.
The 30 patients with CKD ranged in age from 24 to 73 years, and the 30 healthy individuals ranged in age from 25 to 78 years. Both distal and left middle thirds of the Achilles tendons were thicker in patients with CKD than in healthy individuals (P < .05). The mean SRs ± SDs in the patient group (4.71 ± 0.95 and 4.85 ± 1.47 on the right and left, respectively) were significantly higher (P < .05) than in healthy individuals (2.31 ± 0.42 and 2.65 ± 0.55 on the right and left), which indicated an increased stiffness of Achilles tendons in the patient group.
As a semiquantitative and noninvasive imaging modality, strain elastography has the potential to detect the morphologic and elasticity changes of Achilles tendons in patients with CKD, which may give an opportunity to help physicians predict possible leading partial or complete tears.
采用超声弹性成像技术研究慢性肾脏病（CKD）患者跟腱的B型超声（US）特征及弹性，并与健康个体进行比较。
2019年3月至2019年5月，前瞻性纳入30例不同分期的CKD患者和30例健康个体。对所有个体的双侧跟腱进行超声和应变弹性成像检查。如有肌腱病，按照Archambault等人（《临床超声杂志》1998年；26:335 - 339）的定义进行分类，并通过超声记录厚度。通过测量跟腱和Kager脂肪垫的应变值计算应变比（SRs）。计算对照组和CKD患者跟腱SRs的统计学差异。
30例CKD患者年龄在24至73岁之间，30例健康个体年龄在25至78岁之间。CKD患者跟腱的远端和左中三分之一处均比健康个体厚（P < 0.05）。患者组的平均SRs±标准差（右侧和左侧分别为4.71±0.95和4.85±1.47）显著高于健康个体（右侧和左侧分别为2.31±0.42和2.65±0.55）（P < 0.05），这表明患者组跟腱的硬度增加。
作为一种半定量和无创的成像方式，应变弹性成像有潜力检测CKD患者跟腱的形态和弹性变化，这可能为医生预测可能导致的部分或完全撕裂提供机会。
