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| 不同病程T2DM患者采用实时超声弹性成像技术与能量多普勒超声对跟腱异常改变的诊断价值 |
| 沈孔剑,盛静,肖美琴,李平 |
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| (浙江省玉环市第二人民医院超声科;重庆市中医院骨科) |
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| 摘要: |
| 目的：探讨不同病程T2DM患者采用实时超声弹性成像技术与能量多普勒超声对跟腱异常改变的诊断价值。方法：选取135例T2DM患者作为研究对象,研究时间为2017年2月至2020年2月,根据不同糖尿病病程分为A组(病程＜5年)、B组(病程5-10年)、C组(病程＞10年),各45例；其中,A组经MRI确诊为跟腱异常改变共10例,B组经MRI确诊为跟腱异常改变共14例,C组经MRI确诊为跟腱异常改变共17例。均予以实时超声弹性成像技术与能量多普勒超声检测,评估检测后的检出率、cut-off值、约登指数、敏感度、特异度,以及分析ROC曲线。结果：A组经能量多普勒超声检测后Ⅰ级为3例(6.67%)、Ⅱ级为0例、Ⅲ级为0例、0级为42例(93.33%),与金标准相比,存在显著差异(P＜0.05)；B组经检测后Ⅰ级为5例(11.11%)、Ⅱ级为1例(4.44%)、Ⅲ级为0例、0级为39例(86.67%),与金标准相比,存在显著差异(P＜0.05)；C组经检测后Ⅰ级为6例(13.33%)、Ⅱ级为2例(4.44%)、Ⅲ级为0例、0级为37例(82.22%),与金标准相比,存在显著差异(P＜0.05)。A组经实时超声弹性成像技术检测后3级为8例(17.78%)、1级为31例(67.39%)、2级为6例(13.33%),与金标准相比,无显著差异(P＞0.05)；B组经检测后3级为12例(26.67%)、1级为26例(57.78%)、3级为7例(15.56%),与金标准相比,无显著差异(P＞0.05)；C组经检测后3级为15例(33.33%)、1级为23例(51.11%)、2级为7例(15.56%),与金标准相比,无显著差异(P＞0.05)。 C组的RTE应变率比值显著高于A与B组(P＜0.05)；B组RTE应变率比值显著高于A组(P＜0.05)。ROC曲线分析显示,能量多普勒超声、弹性成像分级法、RTE应变率比值的AUC分别为(0.707、0.927、0.541,P＜0.05),敏感度(41.50%、85.40%、22.00%),特异度(100.00%、100.00%、86.20%),约登指数(0.415、0.854、0.082)。结论：实时超声弹性成像技术与能量多普勒超声相比,前者诊断确诊率更高。 |
| 关键词: 实时超声弹性成像技术 能量多普勒超声 2型糖尿病 跟腱异常改变 |
| DOI： |
| 投稿时间：2021-03-29修订日期：2021-03-29 |
| 基金项目: |
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| The diagnostic value of real-time ultrasound elastography and power Doppler ultrasound for abnormal Achilles tendon changes in T2DM patients with different courses |
| Shen kongjian,Sheng Jing,Xiao Meiqin,Li Ping |
| () |
| Abstract: |
| Objective: To explore the diagnostic value of real-time ultrasound elastography and power Doppler ultrasound in the diagnosis of abnormal Achilles tendon changes in T2DM patients with different courses. Methods: 135 patients with T2DM were selected as the research objects. The study period was from February 2017 to February 2020. According to different disease courses, they were divided into group A (disease course <5 years), group B (disease course 5-10 years), and group C (>10 years), 45 cases in each; among them, 10 cases were diagnosed as abnormal Achilles tendon changes in group A by MRI, 14 cases were diagnosed as abnormal Achilles tendon changes in group B by MRI, and group C was diagnosed as abnormal Achilles tendon changes by MRI A total of 17 cases.Real-time ultrasound elastography technology and power Doppler ultrasound detection were performed to evaluate the detection rate, cut-off value, Youden index, sensitivity and specificity after detection, and analyze ROC curve. Results: After power Doppler ultrasound detection in group A, there were 3 cases in grade I (6.67%), 0 cases in grade II, 0 cases in grade III, and 42 cases in grade 0 (93.33%). Compared with the gold standard, there was significant Difference (P＜0.05);In group B, 5 cases (11.11%) of grade I, 1 case of grade II (4.44%), 0 cases of grade III, and 39 cases of grade 0 (86.67%) were tested in group B. Compared with the gold standard, there are significant differences. (P＜0.05);In group C, 6 cases (13.33%) of grade I, 2 cases of grade II (4.44%), 0 cases of grade III, and 37 cases of grade 0 (82.22%) were tested in group C. Compared with the gold standard, there are significant differences. (P<0.05).After being tested by real-time ultrasound elastography technology, group A had 8 cases (17.78%) in grade 3, 31 cases in grade 1 (67.39%), and 6 cases in grade 2 (13.33%). Compared with the gold standard, there was no significant difference ( P>0.05); After the detection of group B, there were 12 cases (26.67%) in grade 3, 26 cases (57.78%) in grade 1, and 7 cases in grade 3 (15.56%). Compared with the gold standard, there was no significant difference ( P>0.05); after the detection of group C, there were 15 cases (33.33%) in grade 3, 23 cases in grade 1 (51.11%), and 7 cases in grade 2 (15.56%). Compared with the gold standard, there was no significant difference ( P>0.05).The ratio of RTE strain rate in group C was significantly higher than that of group A and B (P<0.05); the ratio of RTE strain rate in group B was significantly higher than that of group A (P<0.05).ROC curve analysis showed that the AUC of energy Doppler ultrasound, elastography classification method, and RTE strain rate ratio were (0.707, 0.927, 0.541, P＜0.05), sensitivity (41.50%, 85.40%, 22.00%), specific Degree (100.00%, 100.00%, 86.20%), Youden Index (0.415, 0.854, 0.082).Conclusion: Compared with power Doppler ultrasound, the real-time ultrasound elastography technique has a higher diagnosis rate. |
| Key words: real-time ultrasound elastography technology power Doppler ultrasound type 2 diabetes abnormal changes in the Achilles tendon |
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