Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Eur J Radiol. 2022 Oct;155:110495. doi: 10.1016/j.ejrad.2022.110495. Epub 2022 Aug 20.
This meta-analysis aimed to investigate the utility of ultrasound (US) elastography in the assessment of plantar fasciitis (PF).
We searched PubMed, Embase, and Scopus and systemically reviewed clinical studies that used US elastography for imaging PF. The primary outcome was the comparison of plantar fascia stiffness between healthy controls and patients with PF, quantified using the weighted mean difference (WMD) and standardized mean difference (SMD).
Eleven studies were included in the final systematic review and meta-analysis. In six studies that employed shear wave elastography, patients with PF had a lower shear wave velocity, with a WMD of -1.772 m/s (95 % confidence interval [CI], -2.663 to -0.880) and an SMD of -1.239 m/s (95 % CI, -1.876 to -0.603), compared to those with asymptomatic heels. One study using the strain ratio showed that the WMD and SMD of patients with diseased heels vs healthy controls were -0.400 (95 % CI, -0.850 to 0.050) and -0.442 (95 % CI, -0.946 to 0.062), respectively. In six articles that use the color histogram of strain elastography, less stiffness was consistently reported in the diseased plantar fascia compared with healthy controls.
This meta-analysis showed that the plantar fasciae were less stiff in the PF group than in asymptomatic subjects. The diagnostic performance of US elastography (over B-mode) warrants further investigation.
本荟萃分析旨在探讨超声弹性成像在足底筋膜炎（PF）评估中的应用价值。
我们检索了 PubMed、Embase 和 Scopus，并系统地回顾了使用超声弹性成像对 PF 进行成像的临床研究。主要结局是使用加权均数差（WMD）和标准化均数差（SMD）比较健康对照组和 PF 患者足底筋膜的硬度。
最终有 11 项研究被纳入系统评价和荟萃分析。在 6 项采用剪切波弹性成像的研究中，PF 患者的剪切波速度较低，WMD 为-1.772m/s（95%可信区间 [CI]：-2.663 至 -0.880），SMD 为-1.239m/s（95%CI：-1.876 至 -0.603），与无症状足跟相比。有 1 项研究采用应变比，结果显示，患病足跟与健康对照组相比，WMD 和 SMD 分别为-0.400（95%CI：-0.850 至 0.050）和-0.442（95%CI：-0.946 至 0.062）。在 6 篇采用应变弹性成像彩色直方图的文章中，患病足底筋膜的硬度始终低于健康对照组。
本荟萃分析表明，PF 组足底筋膜的硬度低于无症状组。超声弹性成像（优于 B 型超声）的诊断性能值得进一步研究。
