Real-time Shear Wave Elastography in Evaluating Changes in Muscle and Tendon Tone of the Quadriceps in Parkinson's Disease Patients
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摘要:
目的 运用实时剪切波弹性成像（SWE）技术测量帕金森患者的股四头肌（股直肌、股中间肌、股外侧肌、股内侧肌）各肌肉及肌腱的杨氏模量值，分析帕金森患者肌肉肌腱肌张力的变化。 方法 选取2023年4月至2024年4月在云南大学附属医院经临床确诊的帕金森病（PD）患者共60例纳入研究组，根据帕金森病评定量表的评分及评级，分为A组（症状明显侧，n = 60）、B组（症状较轻侧，n = 60），并选取同期健康受试者60例纳入对照组。采用美国西门子公司的ACUSON Sequoia型超声诊断仪剪切波弹性成像功能，测量放松状态下股四头肌肌肉及肌腱的杨氏模量值（kPa），分析对比股四头肌肌肉及肌腱肌张力的变化。 结果 A组、B组股四头肌（股直肌、股中间肌、股外侧肌、股内侧肌）肌肉的杨氏模量值高于对照组（均 P < 0.05）； A组股中间肌、股外侧肌肌肉的杨氏模量值高于B组（均 P < 0.05）；A组、B组股四头肌肌腱的杨氏模量值高于对照组（均P < 0.05）；A组股四头肌肌腱的杨氏模量值高于B组（均P < 0.05）。 结论 帕金森病患者股四头肌肌肉及肌腱肌张力增高。其中，患者症状明显侧股中间肌、股外侧肌的肌张力高于症状较轻侧，而症状明显侧与较轻侧股直肌、股内侧肌的肌张力无差异。 Abstract:Objective To measure the Young's modulus values of the quadriceps muscles （rectus femoris, vastus intermedius, vastus lateralis, vastus medialis） and tendons in Parkinson's disease （PD） patients using real-time shear wave elastography （SWE） technology, and to analyze the changes in muscle and tendon tone. Methods A total of 60 clinically diagnosed PD patients from Yunnan University Affiliated Hospital between April 2023 and April 2024 were included in the study group. Based on the scores and ratings of PD rating scale, patients were divided into Group A （symptomatic side, n = 60） and Group B （less symptomatic side, n = 60）. An additional 60 healthy subjects were selected as the control group. The shear wave elastography function of the ACUSON Sequoia ultrasound diagnostic device from Siemens USA was used to measure the Young's modulus values （kPa） of the quadriceps muscles and tendons in a relaxed state, and to analyze and compare the changes in muscle and tendon tone. Results The Young's modulus values of quadriceps muscles （rectus femoris, intermedius femoris, vastus lateralis, vastus medialis） in groups A and B were higher than those in control group （P < 0.05）. The Young's modulus values of the intermediate and lateral femoris muscles in group A were higher than that in group B （all P < 0.05）. The Young's modulus values of quadriceps tendon in groups A and B were higher than that in control group. （P < 0.05）. The Young modulus value of quadriceps tendon in group A was higher than that in group B （P < 0.05）. Conclusion Patients with Parkinson's disease exhibit increased muscle and tendon tone in the quadriceps. Notably, the muscle tone of the vastus intermedius and vastus lateralis on the symptomatic side is higher than that on the less symptomatic side, while there is no significant difference in muscle tone between the rectus femoris and vastus medialis on the symptomatic and less symptomatic sides. -
Key words:
- Real-time shear wave elastic imaging /
- Parkinson's disease /
- Quad-riceps /
- Muscular tonex
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图 1 A组、B组、对照组股直肌杨氏模量值声像图
A：A组杨氏模量值：13.0 kPa；B：B组杨氏模量值：12.1 kPa；C：对照组杨氏模量值：5.5 kPa。
Figure 1. Ultrasound images of the Young's modulus values of femoris rectus muscle in group A，group B and control group
图 2 A组、B组、对照组股中间肌杨氏模量值声像图
A：A组杨氏模量值：17.4 kPa；B：B组杨氏模量值：13.4 kPa；C：对照组杨氏模量值：5.2 kPa。
Figure 2. Ultrasound images of the Young's modulus values of femur intermediate muscle in group A，group B and control group
图 3 A组、B组、对照组股外侧肌杨氏模量值声像图
A：A组杨氏模量值：13.0 kPa；B：B组杨氏模量值：10.6 kPa；C：对照组杨氏模量值：5.0 kPa。
Figure 3. Ultrasound images of the Young's modulus values of lateral femur muscle in group A，Group B and control group
图 4 A组、B组、对照组股内侧肌杨氏模量值声像图
A：A组杨氏模量值：11.5 kPa；B：B组杨氏模量值：12.2 kPa；C：对照组杨氏模量值：5.0 kPa。
Figure 4. Ultrasound images of the Young's modulus values of medial femur muscle in group A，group B and control group
图 5 A组（症状明显侧）、B组（症状较轻侧）、对照组股四头肌肌肉杨氏模量值箱型图
A：股直肌；B：股中间肌；C：股外侧肌；D：股内侧肌。***P < 0.001。
Figure 5. Box plot of the Young's modulus values of the quadriceps muscle in group A （side with prominent symptoms），group B （side with milder symptoms），and the control group
图 6 A组、B组、对照组股四头肌肌腱杨氏模量值声像图
A：A组杨氏模量值：70.0 kPa；B：B组杨氏模量值：55.2 kPa；C：对照组杨氏模量值：23.2 kPa。
Figure 6. Ultrasound images of the Young's modulus values of the quadriceps tendon in group A，group B，and the control group
图 7 A组（症状明显侧）、B组（症状明显侧）、对照组股四头肌肌腱杨氏模量值箱型图
***P < 0.001。
Figure 7. Box plot of Young's modulus value of quadriceps tendon in group A （symptomatic side），group B （symptomatic side） and control group
表 1 帕金森病组与对照组基线资料对比（$ \bar x \pm s $）
Table 1. Comparison of baseline data between Parkinson's disease group and control group（$ \bar x \pm s $）
组别 性别（男/女） 年龄（岁） 帕金森病组 31/29 （67.00 ± 8.93） 对照组 30/30 （66.75 ± 5.00） χ2 / t 0.033 −0.188 P 0.855 0.852 
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表 2 A组、B组、对照组股四头肌各肌肉杨氏模量值（kPa）比较（$ \bar x \pm s $ ）
Table 2. Comparison of Young's modulus （kPa） of quadriceps muscles in group A，group B and control group（$ \bar x \pm s $）
分组 股直肌
杨氏模量值（kPa）股中间肌
杨氏模量值（kPa）股外侧肌
杨氏模量值（kPa）股内侧肌
杨氏模量值（kPa）A组（n = 60） 12.99 ± 2.88△ 16.75 ± 3.73△# 14.13 ± 3.34△# 10.84 ± 2.30△ B组（n = 60） 13.15 ± 3.09△ 12.94 ± 2.86△ 11.34 ± 2.79△ 10.78 ± 2.13△ 对照组（n = 60） 5.39 ± 0.27 5.45 ± 0.29 5.30 ± 0.38 5.18 ± 0.35 F 197.294 267.978 191.963 191.460 P < 0.001 * < 0.001 * < 0.001 * < 0.001* 病例组与对照组比较，△P < 0.05；病例组中A组与B组比较，#P < 0.05；*P < 0.05。
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表 3 A组、B组与对照组股四头肌肌腱杨氏模量值（kPa）比较（$ \bar x \pm s $ ）
Table 3. Comparison of Young's modulus （kPa） of quadriceps tendon in groups A，B and control group（$ \bar x \pm s $ ）
分组 股四头肌肌腱杨氏模量值（kPa） A组（n = 60） 61.40 ± 12.27△# B组（n = 60） 48.70 ± 10.87△ 对照组（n = 60） 30.81 ± 4.80 F 145.811 P < 0.001* 病例组与对照组比较，△P < 0.05；病例组中A组与B组比较，#P < 0.05；*P < 0.05。
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[1] 刘兵,杨全,张凯,等. NLRP3炎症小体在帕金森病运动防治中的作用研究进展[J]. 中国免疫学杂志,2024,5(13):1-17. [2] 高含,张黎明. 帕金森病肌张力障碍的诊疗研究新进展[J]. 中国实用神经疾病杂志,2022,25(8):1001-1005. [3] 王丽,段玉成. 帕金森病引发的肌张力障碍[J]. 中老年保健,2018,26(12):26-27. [4] Romanato M,Piatkowska W,Spolaor F. et al. Different perspectives in understanding muscle functions in Parkinson’ s disease through surface electromyography: Exploring multiple activation patterns[J]. Journal of Electromyography and Kinesiology,2022,64:102658. doi: 10.1016/j.jelekin.2022.102658 [5] 李宇璇,韦铭儿,卢晓东. 帕金森病肌强直量化评估方法的研究进展[J]. 浙江医学,2021,43(11):1251-1254. [6] 徐亦乐,车艳玲,刘洋,等. 剪切波弹性成像在肌骨系统疾病诊断上的应用进展[J]. 影像科学与光化学,2024,42(1):77-82. doi: 10.7517/issn.1674-0475.231024 [7] Jenkyn T R,Ehman R L,An K N. Noninvasive muscle tension measurement using the noveltechnique of magnetic resonance elastography (MRE)[J]. Journal of BiomEchanics,2003,36(12):1917-1921. doi: 10.1016/S0021-9290(03)00005-8 [8] 陈海波. 统一帕金森病评定量表[J]. 中华老年医学杂志,1999(1):60-61. doi: 10.3760/j:issn:0254-9026.1999.01.038 [9] 魏鹏绪. 关于改良Ashworth量表的探讨[J]. 中国康复医学杂志,2014,29(1):67-68. [10] 陈永平,商慧芳. 2016中国帕金森病诊断标准解读[J]. 中国实用内科杂志,2017,37(2):124-126. [11] 丁常伟,张迎春,宋馨,等. 实时剪切波弹性成像评估强直型帕金森病患者早期上肢肌肉硬度的变化[J]. 中国医学影像学杂志,2021,29(8):826-830. [12] 孙友胜,陈杰,张建勇,等. 基于超声弹性成像观察2型糖尿病患者股四头肌肌腱改变[J]. 中国医学影像技术,2024,40(1):103-106. [13] 李宇璇. 基于剪切波弹性成像下重复经颅磁刺激对帕金森病人肌肉硬度的疗效评估[D]. 杭州: 杭州师范大学,2021. [14] Li X,Zhou J,He R,et al. A study on the effects of the Qihuang Needle therapy on patients with Parkinson's disease[J]. Frontiers in Neurology,2023,13:1022057. doi: 10.3389/fneur.2022.1022057 [15] 杜丽娟,程令刚,李晨,等. 实时剪切波超声弹性成像技术评估帕金森病患者上肢肌张力的临床研究[J]. 首都医科大学学报,2014,35(2):155-158. [16] 林昆明. 苁蓉舒痉颗粒对帕金森病患者肌张力影响的临床观察[D]. 福州: 福建中医药大学. [17] Parry M S ,El-Ansary D ,Cartwright S M ,et al. Ultrasonography in the intensive care setting can be used to detect changes in the quality and quantity of muscle and is related to muscle strength and function [J]. Journal of Critical Care,2015,30 (5): 1151. e9-1151. e14. [18] 李益平,张颖. 不同角度股四头肌等速肌力训练对全膝关节置换术后膝关节功能的影响[J]. 天津医药,2016,44(1):91-93. -
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