Zeng Lan, Zhang Li, Ma Jiuyi, Huang Jianqiu, Sun Yang
Department of Ultrasound, Peking University Third Hospital, Beijing, China.
Department of Ultrasound, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
BMC Musculoskelet Disord. 2025 May 30;26(1):532. doi: 10.1186/s12891-025-08778-7.
This study evaluated the reproducibility of shear modulus (SM) measurements of the quadriceps muscle in straight and bent knee positions using a quantitative ultrasound elastography device and explored its potential in predicting patellofemoral instability (PFI).
The study included 13 healthy subjects and 34 patients with anterior knee pain. Among the 68 legs of 34 patients, 23 had lateral patellar tilt and 9 had patella alta. The SM of the lateral femoral muscle (LFM), medial femoral muscle (MFM), and rectus femoris muscle (RFM) was measured in both knee straight and bent positions using a quantitative ultrasound device. Intra-observer and inter-observer reliability were assessed by intraclass correlation coefficient (ICC), and the performance of SM values in predicting lateral patellar tilt and patella alta was analyzed using receiver operating characteristic (ROC) curves.
SM measurements of the LFM, MFM, and RFM showed good to excellent intra- and inter-observer reliability (ICC = 0.770-0.993, all P < 0.001). The group with lateral patellar tilt showed significantly higher SM(LFM), SM(L/M), and SM(LFM) compared to the group without lateral patellar tilt. Similarly, SM(RFM) and SM(RFM) of the group with patella alta were significantly higher than those of the group without patella alta. ROC analysis showed that SM(LFM) and SM(LFM) were highly effective in predicting lateral patellar tilt, while SM(RFM) and SM(RFM) were effective for predicting patella alta.
Quantitative elastography ultrasound for measuring quadriceps muscle SM offers a reliable, noninvasive method for assessing mechanical stress around the knee, providing high predictive accuracy for PFI.
本研究使用定量超声弹性成像设备评估了伸直和弯曲膝关节位置时股四头肌剪切模量（SM）测量的可重复性，并探讨了其在预测髌股关节不稳（PFI）方面的潜力。
本研究纳入了13名健康受试者和34名膝关节前侧疼痛患者。在34例患者的68条腿中，23例有髌骨外侧倾斜，9例有高位髌骨。使用定量超声设备在膝关节伸直和弯曲位置测量股外侧肌（LFM）、股内侧肌（MFM）和股直肌（RFM）的SM。通过组内相关系数（ICC）评估观察者内和观察者间的可靠性，并使用受试者工作特征（ROC）曲线分析SM值在预测髌骨外侧倾斜和高位髌骨方面的性能。
LFM、MFM和RFM的SM测量显示出良好至优秀的观察者内和观察者间可靠性（ICC = 0.770 - 0.993，所有P < 0.001）。与无髌骨外侧倾斜的组相比，有髌骨外侧倾斜的组显示出显著更高的SM（LFM）、SM（L/M）和SM（LFM）。同样，有高位髌骨的组的SM（RFM）和SM（RFM）显著高于无高位髌骨的组。ROC分析表明，SM（LFM）和SM（LFM）在预测髌骨外侧倾斜方面非常有效，而SM（RFM）和SM（RFM）在预测高位髌骨方面有效。
用于测量股四头肌SM的定量弹性超声为评估膝关节周围的机械应力提供了一种可靠的非侵入性方法，对PFI具有较高的预测准确性。
