基于下肢肌肉高频超声及剪切波弹性成像参数评估皮肌炎

目的 观察下肢肌肉高频超声（HFUS）及剪切波弹性成像（SWE）参数用于评估皮肌炎（DM）的价值。方法 前瞻性对19例DM患者（DM组）及20名健康体检者（对照组）行下肢肌肉HFUS及SWE检查，对比2组双侧股外侧肌及腓肠肌外侧头肌肉回声、厚度及剪切波速度（SWV），绘制受试者工作特征曲线，计算曲线下面积（AUC），观察各超声参数评估DM的效能。结果 DM组肌肉回声为1分者占比、双侧腓肠肌外侧头肌肉厚度、双侧股外侧肌及腓肠肌外侧头SWV均低于对照组（P均＜0.05）。双侧股外侧肌及左侧腓肠肌外侧头SWV用于评估DM效能优异（AUC为0.932～0.968），双侧腓肠肌外侧头厚度及右侧腓肠肌外侧头SWV评估DM的效能良好（AUC为0.784～0.884），而肌肉回声用于评估DM的效能一般（AUC=0.658）。结论 下肢肌肉HFUS及SWE参数可用于评估DM，尤以SWE参数价值相对较高。

High-frequency ultrasound and shear wave elastography parameters of lower extremity muscles for evaluating dermatomyositis

Objective To observe the value of high-frequency ultrasound （HFUS） and shear wave elastography （SWE） parameters of lower extremity muscles for evaluating dermatomyositis （DM）. Methods Totally 19 DM patients （DM group） and 20 healthy subjects （control group） were prospectively enrolled， and lower extremity muscles HFUS and SWE examinations were performed. The echoes， thickness and shear wave velocity （SWV） of bilateral vastus lateralis and lateral head of gastrocnemius were compared between groups. Receiver operating characteristic curves were drawn， and the area under the curves （AUC） were calculated to evaluate the efficacy of each ultrasonic parameter for evaluating DM. Results The proportion of muscle echo score of 1-point， thickness of bilateral lateral head of gastrocnemius， SWV of bilateral vastus lateralis and lateral head of gastrocnemius in DM group were all lower than those in control group （all P＜0.05）. SWV of bilateral vastus lateralis and left lateral head of gastrocnemius had excellent efficacies for evaluating DM （AUC 0.932—0.968）. The thickness of bilateral lateral head of gastrocnemius and SWV of right lateral head of gastrocnemius had good efficacy for evaluating DM （AUC 0.784—0.884）， while the muscles’ echo had general efficacy （AUC=0.658）. Conclusion HFUS and SWE parameters of lower extremity muscles could be used to evaluate DM， among which SWE parameters had relatively higher values.