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超声弹性成像显示了体位与软组织硬度之间的关系,这与坐姿相关性压疮的病因有关。

Ultrasound elastography reveals the relation between body posture and soft-tissue stiffness which is relevant to the etiology of sitting-acquired pressure ulcers.

机构信息

Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.

Department of Radiology, Haamek Medical Center, Afula, Israel.

出版信息

Physiol Meas. 2021 Jan 1;41(12):124002. doi: 10.1088/1361-6579/abc66d.

Abstract

OBJECTIVE

Sitting-acquired pressure ulcers (PUs) are common in wheelchair users. These PUs are often serious and may involve deep tissue injury (DTI). Investigating the mechanical properties of the tissues susceptible to DTI may help in guiding the prevention and early detection of PUs. In this study, shear wave elastography (SWE) was used to measure the normative mechanical properties of the soft tissues of the buttocks, i.e. skeletal muscle and subcutaneous fat, under the ischial tuberosities, in a convenient sample of healthy adults without weight bearing and with weight bearing of different times.

APPROACH

We compared the stiffness properties of these soft tissues between the lying prone and sitting postures, to determine whether there are detectable property changes that may be associated with the type of posture. We hypothesized that muscle contractions and 3D tissue configurations associated with the posture may influence the measured tissue stiffnesses.

MAIN RESULTS

Our results have shown that indeed, SWE values differed significantly across postures, but not over time in a specific posture or for the right versus left sides of the body.

SIGNIFICANCE

We have therefore demonstrated that soft-tissue stiffness increases when sitting with weight bearing and may contribute to increasing the potential PU risk in sitting compared to lying prone, given the stiffer behavior of tissues observed in sitting postures.

摘要

目的

坐姿所致压疮(PU)在轮椅使用者中很常见。这些压疮通常较为严重,可能涉及深部组织损伤(DTI)。研究易发生 DTI 的组织的力学特性,可能有助于指导压疮的预防和早期发现。本研究采用剪切波弹性成像(SWE)测量坐骨结节下臀部软组织(即骨骼肌和皮下脂肪)在无负重和不同负重时间下的正常力学特性。

方法

我们比较了仰卧位和坐位时这些软组织的硬度特性,以确定是否存在可能与体位类型相关的可检测的性质变化。我们假设与体位相关的肌肉收缩和 3D 组织构型可能会影响测量的组织硬度。

主要结果

我们的结果表明,SWE 值确实因体位而异,但在特定体位或身体的右侧与左侧,SWE 值不会随时间而变化。

意义

因此,我们已经证明,当承重时,软组织的硬度会增加,与仰卧位相比,坐姿时组织的刚性行为观察到,坐姿可能会增加坐姿时发生压疮的潜在风险。

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