超声剪切波弹性成像在脑卒中患者小腿康复评定中的应用

doi:10.3969/j.issn.1006-9771.2020.07.003

Abstract

Abstract:

Objective To apply the ultrasonic shear wave elastography to evaluate triceps surae and Achilles tendon for patients with lower extremity dyskinesia after stroke. Methods Thirty-two inpatients during 2018 and 2019 with unilateral lower extremity dyskinesia after stroke were studied with 2-D ultrasound and shear wave elastography on the bilateral triceps surae and Achilles tendons before and after rehabilitation. Shear wave velocity (SWV) of the triceps surae and the Achilles tendons, the length and thickness of Achilles tendon (soleus tendon) were measured. Results Before rehabilitation, the SWV of the Achilles tendons and the triceps surae increased more in the affected side than in the unaffected side (t > 2.426, P < 0.05), as well as the length of the Achilles tendons ( t = 11.801, P < 0.001). After rehabilitation, the SWV of the triceps surae decreased ( t > 2.447, P < 0.05), as well as the length of the Achilles tendons ( t = 8.577, P < 0.001). Conclusion Ultrasound shear wave elastography can be used to evaluate the elastic characteristics of the Achilles tendon and the triceps surae, to guide the rehabilitation for stroke patients.

Key words: stroke, shear wave ultrasound elastography, Achilles tendon, triceps surae, rehabilitation assessment, muscular tension

CLC Number:

R743.3

GUO Yi,LI Xue-mei,ZHANG Hao,LU Hai-tao,FENG Bing,WANG Yi-zheng. Application of Ultrasound Shear Wave Elastography in Rehabilitaion Assessment of Triceps Surae and Achilles Tendon after Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(7): 753-756.

Figures/Tables 2

References 31

[1]	Sigrist R M S, Liau J, Kaffas A E, et al. Ultrasound elastography: review of techniques and clinical applications[J]. Theranostics, 2017, 7(5): 1303-1329. doi: 10.7150/thno.18650 pmid: 28435467
[2]	刘丽莉, 冯岚, 陶阳, 等. 剪切波弹性成像鉴别诊断桥本甲状腺炎合并甲状腺结节的性质[J]. 中国医学影像技术, 2017, 33(8): 1202-1205.
	Liu L L, Feng L, Tao Y, et al. Value of shear wave elastography in differential diagnosis of Hashimoto's thyroiditis complicated with thyroid nodules[J]. Chin J Med Imag Tech, 2017, 33(8): 1202-1205.
[3]	Sande J A, Verjee S, Vinayak S, et al. Ultrasound shear wave elastography and liver fibrosis: a prospective multicenter study[J]. World J Hepatol, 2017, 9(1): 38-47. doi: 10.4254/wjh.v9.i1.38
[4]	Yerli H, Yilmaz T, Kaskati T. Qualitative and semquantitative evaluations of solid breast lesions by sonoelastography[J]. J Ultrsond Med, 2011, 30(2): 179-186.
[5]	Eby S F, Song P, Chen S, et al. Validation of shear wave elastography in skeletal muscle[J]. J Biomech, 2013, 46(14): 2381-2387. doi: 10.1016/j.jbiomech.2013.07.033
[6]	Bah I, Kwak S T, Chimenti R L, et al. Mechanical changes in the Achilles tendon due toinsertional Achilles tendinopathy[J]. Mech Behav Biomed Mater, 2016, 53:320-328. doi: 10.1016/j.jmbbm.2015.08.022
[7]	Frey H. Realtime elastography: a new ultrasound procedure for the reconstruction of tissue elasticity[J]. Radiologe, 2003, 43(10): 850-855. pmid: 14605701
[8]	李素淑, 刘红梅, 何燕妮, 等. VTIQ技术评价健康青年人群跟腱弹性的重复性研究[J]. 中国超声医学杂志, 2016, 32(8): 738-741.
	Li S S, Liu H M, He Y N, et al. The measurement repeatability of VTIQ technique assessing Achilles's tendon elasticity in healthy youth[J]. Chin J Ultrasound Med, 2016, 32(8): 738-741.
[9]	Zorowitz R D, Gillard P J, Brainin M. Poststroke spasticity: sequelae and burden on stroke survivors and caregivers[J]. Neurology, 2013, 80(3 Suppl 2): S45-S52.
[10]	Brewer L, Horgan F, Hickey A, et al. Stroke rehabilitation: recentadvances and future therapies[J]. QJM, 2013, 106:11-25. doi: 10.1093/qjmed/hcs174 pmid: 23019591
[11]	Gao F, Ren Y, Roth E J. Effects of repeated ankle stretching on calf muscle-tendon and ankle biomeehanieal properties in stroke survivors[J]. Clin Biomech, 2011, 26(5): 516-522. doi: 10.1016/j.clinbiomech.2010.12.003
[12]	Lacomis D. Neuromuscular disorders in critically ill patients: review and update[J]. Clin Neuromuscul Dis, 2011, 12:197-218.
[13]	Tamburini P, Mazzoli D, Stagni R. Towards an objective assessment of motor function in subacute stroke patients: relationship between clinical rating scales and instrumental gait stability indexes[J]. Gait Posture, 2018, 59:58-64. doi: S0966-6362(17)30938-4 pmid: 28988025
[14]	吴艳, 杨建全. 运动动态评估结合镜像治疗对脑卒中患者运动功能及生活质量的影响[J]. 中国老年学杂志, 2017, 37(21): 5380-5381.
	Wu Y, Yang J Q. Effect of dynamic motor assessment combined with mirror image therapy on motor function and quality of life in patients with stroke[J]. Chin J Gerontol, 2017, 37(21): 5380-5381.
[15]	Chino K, Kawakami Y, Takahashi H. Tissue elasticity of in vivo skeletal muscles measured in the transverse and longitudinal planes using shear wave elastography[J]. Clin Physiol Funct Imaging, 2017, 37(4): 394-399.
[16]	Klauser A S, Miyamoto H, Tamegger M, et al. Achilles tendon assessed with sonoelastography: histologic agreement[J]. Radiology, 2013, 267:837-842. doi: 10.1148/radiol.13121936 pmid: 23449953
[17]	Cosgrove D, Piscaglia F, Bamber J, et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: clinical applications[J]. Ultraschall Med, 2013, 34(3): 238-253. doi: 10.1055/s-0033-1335375 pmid: 23605169
[18]	中华神经科学会, 中华神经外科学会. 各类脑血管疾病的诊断要点[J]. 中华神经科杂志, 1996, 29(6): 379-380.
	Chinese Society of Neurology, Chinese Neurosurgical Society. Diagnosis of Cerebral Vascular Diseases[J]. Chin J Neurol, 1996, 29(6): 379-380.
[19]	Wezenbeek E, Mahieu N, Willems T M, et al. What does normal tendon structure look like? New insights into tissue characterization in the Achilles tendon[J]. Scand J Med Sci Sports, 2017, 27(7): 746-753. doi: 10.1111/sms.2017.27.issue-7
[20]	Payne C, Watt P, Cercignani M, et al. Reproducibility of shear wave elastography measures of the Achilles tendon[J]. Skeletal Radiol, 2018, 47(6): 779-784. doi: 10.1007/s00256-017-2846-8
[21]	Ewertsen C, Carlsen J F, Christiansen I R, et al. Evaluation of healthy muscle tissue by strain and shear wave elastography dependency on depth and ROI position in relation to underlying bone[J]. Ultrasonics, 2016, 71:127-133. doi: 10.1016/j.ultras.2016.06.007
[22]	van Schie H T, de Vos R J, de Jonge S, et al. Ultrasonographic tissue characterisation of human Achilles tendons: quantification of tendon structure through a novel non-invasive approach[J]. Br J Sports Med, 2010, 44(16): 1153-1159. doi: 10.1136/bjsm.2009.061010
[23]	李亚梅, 冯荣建, 黄林, 等. 不同输出压力体外冲击波对脑卒中后小腿三头肌痉挛的影响[J]. 中国康复理论与实践, 2019, 25(5): 518-523.
	Li Y M, Feng R J, Huang L, et al. Effects of extracorporeal shock wave therapy in different output pressures on triceps surae spasticity after stroke[J]. Chin J Rehabil Theory Pract, 2019, 25(5): 518-523.
[24]	Wissel J, Manack A, Brainin M. Toward an epidemiology of poststroke spasticity[J]. Neurology, 2013, 80(3 Suppl 2): S13-S19.
[25]	Cortez C D, Hermitte L, Ramain A, et al. Ultrasound shear wave velocity in skeletal muscle: a reproducibility study[J]. DiagnInterv Imaging, 2016, 97(1): 71-79.
[26]	Leung W K C, Chu K L, Lai C. Sonographic evaluation of the immediate effects of eccentric heel drop exercise on Achilles tendon and gastrocnemius muscle stiffness using shear wave elastography[J]. PeerJ, 2017, 5:e3592. doi: 10.7717/peerj.3592
[27]	Nakamura M, Ikezoe T, Kobayashi T, et al. Acute effects of static stretching on muscle hardness of the medial gastrocnemius muscle belly in humans: an ultrasonic shear wave elastography study[J]. Ultrasound Med Biol, 2014, 40(9): 1991-1997. doi: 10.1016/j.ultrasmedbio.2014.03.024
[28]	Yelnik A P, Simon O, Parratte B, et al. How to clinically assess and treat muscle overactivity in spastic paresis[J]. J Rehabil Med, 2010, 42:801-807. doi: 10.2340/16501977-0613 pmid: 20878038
[29]	Naro A, Leo A, Russo M, et al. Breakthroughs in the spasticity management: are non-pharmacological treatments the future?[J]. J Clin Neurosci, 2017, 39:16-27. doi: 10.1016/j.jocn.2017.02.044
[30]	Ooi C C, Schneider M E, Malliaras P, et al. Sonoelastography of the Achilles tendon: prevalence and prognostic value among asymptomatic elite Australian rules football players[J]. Clin J Sport Med, 2016, 26(4): 299-306. doi: 10.1097/JSM.0000000000000265
[31]	Yamamoto Y, Yamaguchi S, Sasho T, et al. Quantitative ultrasound elastography with an acoustic coupler for Achilles tendon elasticity: measurement repeatability and normative values[J]. Ultrasound Med, 2016, 35(1): 159-166.

组别	腓肠肌内侧头	腓肠肌外侧头	比目鱼肌
健侧	1.90±0.22	1.83±0.20	1.83±0.29
患侧治疗前	2.20±0.49	2.05±0.48	1.97±0.48
患侧治疗后	2.10±0.44	1.91±0.30	1.90±0.40
t_a值	3.911	2.940	2.426
P_a值	< 0.001	0.006	0.021
t_b值	2.447	3.143	2.487
P_b值	0.020	0.004	0.018
t_c值	2.977	1.332	1.422
P_c值	0.006	0.193	0.164

组别	长度(cm)	厚度(cm)	SWV (m/s)
健侧	7.98±1.89	0.48±0.04	7.73±1.06
患侧治疗前	9.43±2.32	0.48±0.06	8.17±0.92
患侧治疗后	8.66±2.02	0.47±0.06	8.06±0.82
t_a值	11.801	0.418	2.810
P_a值	< 0.001	0.679	0.009
t_b值	8.577	1.341	2.012
P_b值	< 0.001	0.190	0.053
t_c值	7.726	0.319	2.187
P_c值	< 0.001	0.752	0.036

Application of Ultrasound Shear Wave Elastography in Rehabilitaion Assessment of Triceps Surae and Achilles Tendon after Stroke

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