实时剪切波超声弹性成像技术评估肌肉减少症患者骨骼肌弹性模量的研究

摘 要 目的 研究肌肉减少症患者股四头肌、腘绳肌和肱二头肌长轴剪切波速度（SWV）值特征，探讨实时剪切波超声弹性成像技术（SWE）评估肌肉减少症患者肌肉状态的应用价值。方法 选择22例肌肉减少症患者（病变组）和21例同期年龄、性别匹配的健康体检者（对照组），应用剪切波超声弹性成像技术，获取病变组和对照组优势侧的股四头肌4块肌肉［股外侧肌（VL），股直肌（RF），股内侧肌（VM）和股中间肌（VI）］，腘绳肌3块肌肉［股二头肌（BF），半腱肌（ST）和半膜肌（SM）］和肱二头肌（BB）松弛状态下长轴SWV值，并进行对比分析。结果 松弛状态下病变组与对照组的VL、RF、VM、VI、BF、ST、SM和BB肌肉的SWV数值差异有显著统计学意义(均P＜0.001)。松弛状态下病变组与对照组比较，VL、RF、VM、VI、BF、ST、SM和BB肌肉的SWV数值分别降低7.8%、7.0%、7.3%、7.3%、7.1%、7.3%、6.5%和6.7%。与对照组比较，病变组SM长轴的SWV值降低最小，VL长轴的SWV值降低最为显著。年龄和BMI指数均为老年人骨骼肌弹性模量的影响因素。结论 实时剪切波超声弹性成像技术可检测肌肉减少症患者较大骨骼肌弹性差异，为评估肌肉减少症患者肌肉状态提供了一种新的检测方法。

Assessment of skeletal muscle elastic modulus in patients with sarcopenia using real-time shear wave elastography

ABSTRACT Objective To investigate the characteristics of long axis shear wave velocity (SWV) values of the quadriceps femoris, the hamstrings and the biceps brachii in patients with sarcopenia and to investigate the value of real-time shear wave elastography (SWE) in assessing muscle status in patients with sarcopenia. Methods 22 patients with sarcopenia (lesion group) and 21 age- and sex-matched healthy subjects (control group) were selected. Shear wave elastography was used to obtain SWV values in the long axis of four quadriceps femoris muscles vastus lateralis (VL), rectus femoris (RF), vastus medialis (VM) and vastus intermedius (VI)], three hamstrings biceps femoris (BF), semitendinosus (ST) and semimembranosus (SM)] and biceps brachii (BB) relaxation on the dominant side of the lesion control group, and a comparative analysis was performed. Results There were significant differences in the SWV values of the VL, RF, VM, VI, BF, ST, SM and BB muscles between the lesion group and the control group in the relaxed state (all P <0.001). Compared with the control group in the relaxed state, the SWV values of lesion group of VL, RF, VM, VI, BF, ST, SM and BB muscles were decreased by 7.8%, 7.0%, 7.3%, 7.3%, 7.1%, 7.3%, 6.5% and 6.7%. And the reduction of muscle elasticity in the long axis of SM was the least in the lesion group, while the reduction of muscle elasticity in the long axis of VL was the most significant. In addition, both age and BMI are factors influencing the elastic modulus of skeletal muscle in the elderly. Conclusion The real-time shear wave ultrasound elastography can detect the difference of elastic modulus in skeletal muscle of patients with sarcopenia, and provides a new detection method for assessing the muscle status of sarcopenia patients.