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钳夹型股骨髋臼撞击症髂腰肌的超声及剪切波弹性成像特征。

Ultrasound and shear-wave elastography characteristics of the iliocapsularis muscle in pincer-type femoroacetabular impingement.

机构信息

Department of Ultrasound, Peking University Third Hospital, Beijing, China.

Department of Sports Medicine, Peking University Third Hospital, Beijing, China.

出版信息

PM R. 2022 Nov;14(11):1360-1367. doi: 10.1002/pmrj.12707. Epub 2021 Nov 2.

Abstract

BACKGROUND

The iliocapsularis muscle is a structure of the anterior hip, which may play a key role in stabilizing the hip joint, but to our knowledge no studies exist describing ultrasound (US) and shear-wave characteristics of this muscle.

OBJECTIVES

To investigate the anatomic dimensions and elasticity of the iliocapsularis muscle in patients with pincer-type femoroacetabular impingement (FAI) and normal hips using gray-scale US and shear-wave elastography (SWE).

DESIGN

Case-control study.

SETTING

Sports medicine and ultrasound department within a tertiary hospital.

PARTICIPANTS

Thirty-three patients (33 hips) with pincer-type FAI and 37 healthy volunteers (37 hips).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

US parameters (anteroposterior diameter, transverse diameter and circumference) of the iliocapsularis muscle in patients with pincer-type FAI and volunteers. Shear-wave velocity and Young's modulus of the iliocapsularis muscle in patients with pincer-type FAI and volunteers in both neutral and external rotation positions.

RESULTS

Significant differences were not observed in the anatomic dimensions of the iliocapsularis muscle between patients with pincer-type FAI and volunteers. The iliocapsularis muscle in patients with pincer-type FAI had significantly lower shear-wave velocity and Young's modulus than the volunteers (p < .05). The cutoff value of the maximum velocity in the external rotation position was 3.35 m/s, which separated pincer-type FAI patients from volunteers and revealed the highest accuracy with sensitivity, specificity, and accuracy of 78.8%, 48.6%, and 64.3%, respectively.

CONCLUSION

The anatomic dimensions of the iliocapsularis muscle in pincer-type FAI patients and volunteers were similar; however, iliocapsularis stiffness in patients with pincer-type FAI was significantly lower than that of the volunteers. SWE can demonstrate altered muscle stiffness of the iliocapsularis muscle in pincer-type FAI patients, which might be used to help make clinical decisions.

摘要

背景

髂腰肌是髋关节前侧的一个结构,它可能在稳定髋关节方面发挥着关键作用,但据我们所知,目前尚无研究描述该肌肉的超声(US)和剪切波特征。

目的

使用灰阶超声和剪切波弹性成像(SWE)研究钳夹型股骨髋臼撞击症(FAI)患者和正常髋关节髂腰肌的解剖学尺寸和弹性。

设计

病例对照研究。

设置

三级医院的运动医学和超声科。

参与者

33 例(33 髋)钳夹型 FAI 患者和 37 名健康志愿者(37 髋)。

干预措施

不适用。

主要观察指标

钳夹型 FAI 患者和志愿者髂腰肌的 US 参数(前后径、横径和周长)。钳夹型 FAI 患者和志愿者在中立位和外旋位时髂腰肌的剪切波速度和杨氏模量。

结果

钳夹型 FAI 患者与志愿者髂腰肌的解剖学尺寸无显著差异。钳夹型 FAI 患者髂腰肌的剪切波速度和杨氏模量明显低于志愿者(P<.05)。外旋位最大速度的截断值为 3.35m/s,可将钳夹型 FAI 患者与志愿者区分开来,其灵敏度、特异性和准确性分别为 78.8%、48.6%和 64.3%,准确性最高。

结论

钳夹型 FAI 患者和志愿者髂腰肌的解剖学尺寸相似;然而,钳夹型 FAI 患者髂腰肌的僵硬程度明显低于志愿者。SWE 可以显示钳夹型 FAI 患者髂腰肌的肌肉僵硬程度改变,这可能有助于做出临床决策。

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