《中国康复理论与实践》

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (6): 738-744.doi: 10.3969/j.issn.1006-9771.2023.06.017

• 应用研究 • 上一篇    

超声回声强度评价膝骨关节炎患者股四头肌质量的信度

李俊毅1, 陈泽华2, 吴祖贵1, 王毅1, 李聪聪1, 王帅1, 陈伟健1, 叶子璇1, 沈星星1, 向瑞安1, 刘文刚1,3, 许学猛1,3()   

  1. 1.广州中医药大学第五临床医学院，广东广州市 510405
    2.株洲市中医伤科医院，湖南株洲市 412007
    3.广东省第二中医院，广东广州市 510405
  • 收稿日期:2023-01-23 修回日期:2023-03-12 出版日期:2023-06-25 发布日期:2023-07-14
  • 通讯作者: 许学猛(1964-)，男，汉族，广东饶平县人，主任医师，教授，主要研究方向：中医药防治退行性骨关节病的基础与临床研究。E-mail： xuxuemeng@163.com
  • 作者简介:李俊毅(1992-)，男，汉族，河南洛阳市人，博士研究生，主要研究方向：中医药防治退行性骨关节病的基础与临床研究。
  • 基金资助:
    1.广州市科技计划项目(202206010048);2.广东省基础与应用基础研究基金项目(2022A1515220157);3.广东省基础与应用基础研究基金项目(2021A1515011545);4.广东省科技计划项目(2021B1111610007)

Reliability on evaluation of quadriceps femoris muscle quality by ultrasonic echo intensity in patients with knee osteoarthritis

LI Junyi1, CHEN Zehua2, WU Zugui1, WANG Yi1, LI Congcong1, WANG Shuai1, CHEN Weijian1, YE Zixuan1, SHEN Xingxing1, XIANG Ruian1, LIU Wengang1,3, XU Xuemeng1,3()   

  1. 1. The Fifth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong 510405, China
    2. Zhuzhou Traumatology Hospital of Traditional Chinese Medicine, Zhuzhou, Hunan 412007, China
    3. Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong 510405, China
  • Received:2023-01-23 Revised:2023-03-12 Published:2023-06-25 Online:2023-07-14
  • Contact: E-mail: xuxuemeng@163.com
  • Supported by:
    Guangzhou Science and Technology Plan Project(202206010048);Guangdong Provincial Basic and Applied Research Foundation(2022A1515220157);Guangdong Provincial Basic and Applied Research Foundation(2021A1515011545);Guangdong Provincial Science and Technology Plan Project(2021B1111610007)

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摘要：

目的 评价超声对膝骨关节炎(KOA)患者股四头肌质量评估的评定者间信度和重测信度。
方法 2021年3月至12月，广东省第二中医院就诊的单侧KOA患者33例，采用肌骨超声观察双下肢股直肌、股内侧肌和股外侧肌的横截面并保存图像，由两名单独评定者采用Image J分析肌肉超声图像平均灰度值，其中1名评定者重复该测量。计算组内相关系数(ICC)、测量标准误差(SEM)、最小可检测变化(MDC)和变异系数(CV)，并将测量结果绘制成Bland-Altman图。
结果 患侧股直肌、股内侧肌和股外侧肌的平均灰度值均大于健侧(t > 2.262, P < 0.05)。评定者间信度均为优秀(ICC = 0.982~0.995)，SEM为1.60~3.82，CV为1.49%~5.90%，MDC为4.43~10.59；重测信度均为优秀(ICC = 0.969~0.990)，SEM为2.37~5.41，CV为2.22%~4.84%，MDC为6.57~15.00。Bland-Altman图形分析显示散点分布具有良好的一致性。
结论 单侧KOA患者患侧与健侧股四头肌质量存在差异。采用开源软件Image J评估KOA患者肌肉超声的回声强度可靠。

关键词: 膝骨关节炎, 股四头肌, 肌骨超声, 信度

Abstract:

Objective To evaluate the inter-rater and test-retest reliability of echo intensity of ultrasound image for quality of quadriceps femoris in patients with knee osteoarthritis (KOA).
Methods From March to December, 2021, 33 patients with unilateral KOA in Guangdong Provincial Second Hospital of Traditional Chinese Medicine were included. Ultrasound was used to observe the cross sections of rectus femoris (RF), vastus medialis (VM) and vastus lateralis (VL), and the images were saved. Two independent raters analyzed the average gray value of the picture with the Image J. One of the raters repeated the measurement. The intra-class correlation coefficient (ICC), standard error of measurement (SEM), minimum detectable change (MDC) and coefficient of variation (CV) were calculated and the Bland-Altman charts were drawn.
Results The gray value was higher in the RF, VM and VL in the affected side than in the healthy side (t > 2.262, P < 0.05). The inter-rater reliability was excellent, with ICC 0.982 to 0.995, SEM 1.60 to 3.82, CV 1.49% to 5.90%, and MDC value 4.43 to 10.59. The test-retest reliability of the rater was excellent, with ICC 0.969 to 0.990, SEM 2.37 to 5.41, CV 2.22% to 4.84%, and MDC value 6.57 to 15.00. Bland-Altman charts analysis showed that the consistency was good.
Conclusion The quadriceps femoris muscle quality is different between the affected and the healthy sides in patients with unilateral KOA. It is reliable to evaluate muscle echo intensity by Image J.

Key words: knee osteoarthritis, quadriceps femoris, musculoskeletal ultrasound, reliability

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