Wang Roumei, Fu Shien, Huang Rui, Qiu Chengcheng, Tang Yunxia, Liu Yaoli
Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Int J Gen Med. 2024 Aug 17;17:3541-3554. doi: 10.2147/IJGM.S472442. eCollection 2024.
This study aimed to evaluate the quadriceps femoris in patients with chronic thyrotoxic myopathy (CTM) using musculoskeletal ultrasound and to explore its practical clinical value for the diagnosis of CTM.
A total of 241 subjects recruited from the First Affiliated Hospital of Guangxi Medical University were surveyed for detailed medical history and underwent grip strength tests, fixed-distance walking, and quadriceps femoris ultrasound examinations. Differences in muscle parameters between the CTM, non-CTM, and healthy groups were analyzed. An Receiver operating characteristic (ROC) curve was established to analyze the predictive value of various ultrasound measurements for CTM, and Spearman correlation analysis and binary logistic regression were applied to explore the factors associated CTM.
The quadriceps femoris contraction index, muscle thickness, muscle cross-sectional area, and pennation angle in the CTM group were significantly lower than those in the non-CTM and healthy groups (<0.01). The ROC curve prediction showed that the pennation angle had the best sensitivity and specificity for diagnosing myogenesis, with an area under the curve of 89%. Moreover, the pennation angle of the CTM group was positively correlated with step speed (r=0.245, =0.031) and body surface area (r=0.276, =0.014), but negatively correlated with age (r=-0.306, =0.007). Regression analysis showed that the quadriceps femoris contraction index, muscle thickness, pennation angle, and cross-sectional area were factors that related the CTM. After adjusting for potential confounding factors, the association between Muscle Bundle Length and CTM became significant (OR=1.99, 95% CI: 1.22, 3.35, =0.007). Muscular echo in patients was observed to varying degrees of enhancement.
Musculoskeletal ultrasonography in the quantitative analysis of muscle parameters and muscle echo of the quadriceps femoris can provide essential imaging evidence for predicting CTM.
本研究旨在利用肌肉骨骼超声评估慢性甲状腺毒症性肌病（CTM）患者的股四头肌，并探讨其对CTM诊断的实际临床价值。
对广西医科大学第一附属医院招募的241名受试者进行详细病史调查，并进行握力测试、定距离行走和股四头肌超声检查。分析CTM组、非CTM组和健康组之间肌肉参数的差异。建立受试者工作特征（ROC）曲线分析各种超声测量对CTM的预测价值，并应用Spearman相关性分析和二元逻辑回归探讨与CTM相关的因素。
CTM组股四头肌收缩指数、肌肉厚度、肌肉横截面积和羽状角均显著低于非CTM组和健康组（<0.01）。ROC曲线预测显示，羽状角对诊断肌生成具有最佳的敏感性和特异性，曲线下面积为89%。此外，CTM组的羽状角与步速（r=0.245，P=0.031）和体表面积（r=0.276，P=0.014）呈正相关，但与年龄（r=-0.306，P=0.007）呈负相关。回归分析表明，股四头肌收缩指数、肌肉厚度、羽状角和横截面积是与CTM相关的因素。在调整潜在混杂因素后，肌束长度与CTM之间的关联变得显著（OR=1.99，95%CI：1.22，3.35，P=0.007）。观察到患者肌肉回声有不同程度的增强。
肌肉骨骼超声对股四头肌肌肉参数和肌肉回声进行定量分析可为预测CTM提供重要的影像学依据。
