高帧率剪切波评价血液透析患者冈上肌腱的力学性能

doi:10.3969/j.issn.1006-7795.2023.06.005

首都医科大学学报 ›› 2023, Vol. 44 ›› Issue (6): 936-940.doi: 10.3969/j.issn.1006-7795.2023.06.005

高帧率剪切波评价血液透析患者冈上肌腱的力学性能

庄佳绵¹，曾宇然²，陈绍琦^1*

1. 汕头大学医学院第一附属医院超声科，广东汕头 515041；2. 汕头大学医学院第一附属医院血液净化科，广东汕头 515041

收稿日期:2023-09-05 出版日期:2023-12-21 发布日期:2023-12-20
通讯作者: 陈绍琦 E-mail:1036587183@qq.com
基金资助:
2021年广东省科技专项资金（“大专项+任务清单”)项目(210716126901097), 2022年汕头市科技计划医疗卫生类别项目(20516096491790), 2023中国超声医师科技新星科研项目A类资助。

Evaluation of the mechanical properties of supraspinatus tendons in hemodialysis patients with high frame rate sound touch elastography

Zhuang Jiamian¹, Zeng Yuran², Chen Shaoqi^1*

1.Department of Ultrasound, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China; 2.Department of Blood Purification, First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong Province, China

Received:2023-09-05 Online:2023-12-21 Published:2023-12-20
Supported by:
This study was supported by the Guangdong Province Science and Technology Special Fund Project (210716126901097), Shantou Science and Technology Project(220516096491790), 2023 China Ultrasonographers' Rising Stars of Science and Technology Research Program, Class A Grant.

摘要/Abstract

摘要： 目的基于高帧率剪切波（high frame rate sound touch elastography，HiFR STE)评价血液透析患者冈上肌腱的力学性能。方法选取汕头大学医学院第一附属医院规律血液透析的患者46例和健康志愿者23例。通过透析龄中位数（74.5个月)将血液透析患者分为透析龄较短组［49.00（14.00, 69.00)］和透析龄较长组［91.00（78.00，122.00)］。使用迈瑞Resona R9 Pro超声诊断仪及L15-3Wu线阵探头进行二维超声和HiFR STE成像，测量并比较不同透析龄的血液透析患者和健康对照组的冈上肌腱厚度及杨氏模量平均值（the mean of Young's modulus，Emean)的差异,并观察各组间肩关节的骨质破坏、滑膜增厚及关节积液常规声像特征。结果健康对照组、透析龄较短组及透析龄较长组的冈上肌腱厚度和Emean值在3组间差异有统计学意义（P<0.001)，冈上肌腱厚度分别为（5.73±0.70）mm、（6.57±0.93）mm和（6.80±0.84）mm，两两比较结果显示不同透析龄的血液透析患者冈上肌腱厚度均高于对照组（P<0.05)；HiFR STE测得3组的冈上肌腱Emean值分别为（61.27±21.64）kPa、（42.56±25.30）kPa和（31.13±17.40）kPa，两两比较结果显示不同透析龄的血液透析患者冈上肌腱Emean值均低于对照组（P<0.05)；骨侵蚀率及滑膜增厚率在3组间的差异具有统计学意义（P<0.05)。结论血液透析患者的冈上肌腱增厚及出现力学性能下降。基于HiFR STE技术测得的Emean对血液透析患者冈上肌腱的力学性能进行定量评估，可为临床筛选肩袖撕裂的潜在风险人群提供客观依据。

关键词: 超声, 弹性成像, 高帧率剪切波, 冈上肌腱, 透析

Abstract: Objective To evaluate the mechanical properties of supraspinatus tendons in hemodialysis patients with high frame rate sound touch elastography （HiFR STE). Methods Forty-six patients who routinely underwent hemodialysis at the First Affiliated Hospital of Shantou University Medical College, as well as twenty three fit volunteers, were selected for the study. Patients on hemodialysis were divided into two groups based on their median dialysis duration （74.5 months)： the shorter dialysis duration group and the prolonged dialysis duration group ［49.00（14.00, 69.00) vs 91.00（78.00, 122.00)］. Two-dimensional ultrasound and HiFR STE imaging were performed using a Mindray Resona R9 Pro ultrasound diagnostic instrument and an L15-3Wu line array probe. The supraspinatus tendon thickness and the mean of Young's modulus （Emean)were measured and compared between hemodialysis patients with varying durations of dialysis and healthy controls. Additionally, the sonographic characteristics of the shoulder joint were observed, including bone destruction, synovial hypertrophy, and joint effusion. Results The differences in supraspinatus tendon thickness and Emean values among healthy control group, shorter dialysis age group and longer dialysis age group were statistically significant（P<0.001), with the supraspinatus tendon thickness (5.73±0.70)mm, (6.57±0.93)mm and (6.80±0.84)mm, respectively. The result of two-by-two comparisons showed that the supraspinatus tendons thickness were thicker in both groups of hemodialysis patients with differing dialysis durations than in controls（P<0.05). HiFR STE results showed that their Emean values was (61.27±21.64)kPa、(42.56±25.30)kPa and (31.13±17.40)kPa, respectively. The result of two-by-two comparisons showed that the Emean value of supraspinatus tendons was significantly lower in dialysis patients than in controls, and the incidence of bone erosion and synovial thickening were statistically significant among the three groups（P<0.05). Conclusion Supraspinatus tendons in hemodialysis patients thickened and showed decreased mechanical properties. Quantitative evaluation of supraspinatus tendon elasticity in hemodialysis patients based on the Emean measured by the HiFR STE can provide objective evidence for clinical screening of potential group of rotator cuff tears.

Key words: ultrasound, elastography, high frame rate sound touch elastography（HiFR STE), supraspinatus tendon, dialysis

中图分类号:

R445

庄佳绵, 曾宇然, 陈绍琦. 高帧率剪切波评价血液透析患者冈上肌腱的力学性能[J]. 首都医科大学学报, 2023, 44(6): 936-940.

Zhuang Jiamian, Zeng Yuran, Chen Shaoqi. Evaluation of the mechanical properties of supraspinatus tendons in hemodialysis patients with high frame rate sound touch elastography[J]. Journal of Capital Medical University, 2023, 44(6): 936-940.

参考文献

［1］王洁莲,周静. 维持性血液透析患者并发双侧股四头肌肌腱断裂一例［J］. 中国临床新医学,2021, 14 (7)： 709－711.
［2］Koh K H，Arimuthu D A. Association of incidence rate of spontaneous tendon rupture and renal bone disease in end-stage renal disease patients' cohort ［J］. Semin Dial,2023, doi： 10.1111/sdi.13145. Online ahead of print.
［3］Wu K T,Chou W Y,Ko J Y, et al. Inferior outcome of rotator cuff repair in chronic hemodialytic patients ［J］. BMC Musculoskelet Disord,2019, 20 (1)： 209.
［4］Sommer R,Valen G J,Ori Y et al. Sonographic features of dialysis-related amyloidosis of the shoulder ［J］. J Ultrasound Med,2000, 19 (11)： 765－770.
［5］Soyupek F,Demir M,Suslu F E, et al. The upper extremity musculoskeletal complications in dialysis patients： comparison between hemodialysis and peritoneal dialysis ［J］. J Back Musculoskelet Rehabil,2013, 26 (3)： 267－371.
［6］Tharwat S,Nagy E,Mohsen M, et al. Ultrasound versus magnetic resonance imaging in the evaluation of shoulder pain in end stage renal disease patients on chronic hemodialysis ［J］. Int J Clin Pract,2022, 2022: 1315446.
［7］Serifoglu I,Guneyli S,Ilker Oz I, et al. Acoustic radiation force impulse (ARFI) elastography in evaluation of supraspinatus tendinopathy ［J］. Curr Med Imaging,2023, 19 (6)： 631－635.
［8］LaCroix A S,Duenwald-Kuehl S E,Lakes R S, et al. Relationship between tendon stiffness and failure： a metaanalysis ［J］. J Appl Physiol (1985),2013, 115 (1)： 43－51.
［9］Stiver M L,Mirjalili S A.Agur A M R. Measuring shear wave velocity in adult skeletal muscle with ultrasound 2-D shear wave elastography： a scoping review ［J］. Ultrasound Med Biol,2023, 49 (6)： 1353－1362.
［10］Martinoli C. Musculoskeletal ultrasound： technical guidelines ［J］. Insights Imaging,2010, 1 (3)： 99－141.
［11］Tang X,Wang J,Guo R, et al. Quantitative evaluation of the Achilles tendon and supraspinatus tendon in end-stage kidney disease patients： a potential tool for predicting spontaneous tendon rupture ［J］. Ther Apher Dial,2022, 26 (4)： 734－742.
［12］Hou S W,Merkle A N,Babb J S, et al. Shear wave ultrasound elastographic evaluation of the rotator cuff tendon ［J］. J Ultrasound Med,2017, 36 (1)： 95－106.
［13］Weinreb J H,Sheth C,Apostolakos J, et al. Tendon structure, disease, and imaging ［J］. Muscles Ligaments Tendons J,2014, 4 (1)： 66－73.
［14］Rosskopf A B,Ehrmann C,Buck F M, et al. Quantitative shear-wave US elastography of the supraspinatus muscle： reliability of the method and relation to tendon integrity and muscle quality ［J］. Radiology,2016, 278 (2)： 465－474.
［15］徐森胤,吕娟,骆芬霞，等. 超声联合弹性成像对长期血透患者肩关节淀粉样变的诊断价值［J］. 中国超声医学杂志,2023, 39 (1)： 81－85.
［16］Prado-Costa R,Rebelo J,Monteiro-Barroso J, et al. Ultrasound elastography： compression elastography and shear-wave elastography in the assessment of tendon injury ［J］. Insights Imaging,2018, 9 (5)： 791－814.
［17］Park J H,Kim S B,Shin H S, et al. Spontaneous and serial rupture of both Achilles tendons associated with secondary hyperparathyroidism in a patient receiving long-term hemodialysis ［J］. Int Urol Nephrol,2013, 45 (2)： 587－590.
［18］Turk A C,Fidan N,Ozcan O, et al. Painful and painless shoulder magnetic resonance imaging comparisons in hemodialysis patients and correlation with clinical findings ［J］. J Back Musculoskelet Rehabil, 2017, 30 (1)： 63－69.
［19］Owen Jr W F,Hou F F,Stuart R O, et al. Beta 2-microglobulin modified with advanced glycation end products modulates collagen synthesis by human fibroblasts ［J］. Kidney Int,1998, 53 (5)： 1365－1373.
［20］Ureten K,Ozturk M A,Ozbek M, et al. Spontaneous and simultaneous rupture of both Achilles tendons and pathological fracture of the femur neck in a patient receiving long-term hemodialysis ［J］. Int Urol Nephrol,2008, 40 (4)： 1103－1106.
［21］陈伟文,何燕妮,李素淑，等. 声触诊组织成像量化技术评估正常人群冈上肌腱弹性变化［J］. 中国医学影像技术,2018, 34 (10)： 1549－1553.
［22］Sendur H N,Cindil E,Cerit M N, et al. Evaluation of effects of aging on skeletal muscle elasticity using shear wave elastography ［J］. Eur J Radiol,2020, 128: 109038.

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高帧率剪切波评价血液透析患者冈上肌腱的力学性能

Evaluation of the mechanical properties of supraspinatus tendons in hemodialysis patients with high frame rate sound touch elastography

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