| 摘要: |
| 目的：探讨剪切波弹性成像技术（SWE）在血友病性关节病患者膝关节软骨早期受损中的检测价值，以期为血友病性关节病患者膝关节软骨早期受损提供新的检查方法。方法：选择2022年6月-2023年11月就诊于我院的膝关节反复出血的26例男性血友病A患者和年龄、身高及体重相匹配的男性健康志愿者30例作为研究对象。对两组的膝关节进行常规二维超声检查，获取膝关节不同部位的软骨厚度值并进行HEAD-US-C评分；进一步行膝关节软骨SWE检查，获得其杨氏模量值和剪切波速度值。分析两组膝关节不同部位软骨厚度、杨氏模量、剪切波速度之间是否具有统计学差异。对轻、中、重度血友病患者分层分析所测参数是否具有统计学差异。统计病例组患者HEAD-US-C评分与膝关节不同部位软骨的杨氏模量和剪切波速度是否具有相关性。结果：（1）病例组与对照组膝关节不同部位软骨厚度组间两两比较差异均有统计学意义（P＜0.05），髁间及外侧髁软骨杨氏模量及剪切波传播速度组间两两比较差异均有统计学意义（P＜0.05）（2）轻、中、重度病例组患者膝关节不同部位软骨厚度组间两两比较差异无统计学意义（P＞0.05）。血友病性关节病患者膝关节髁间及外侧髁软骨杨氏模量及剪切波速度在轻、中、重度三组间相比，除中度组与重度组间比较差异无统计学意义外（P＞0.05），其余参数三组间两两比较差异均有统计学意义（P<0.05）。（3）病例组患者膝关节软骨杨氏模量、剪切波速度与HEAD-US-C评分之间存在负相关性，即病例组患者膝关节软骨硬度随分值的增加而降低。结论：SWE可以定量测量膝关节软骨的硬度变化，从力学指标检测可以较常规超声能更敏感地检出血友病性关节病患者软骨的早期受损。 |
| 关键词: 血友病性关节病 剪切波弹性成像 关节软骨 HEAD-US-C评分 |
| DOI： |
| 投稿时间：2024-02-02修订日期：2024-02-23 |
| 基金项目:惠州市医疗卫生领域科技计划项目（2023CZ010157）, |
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| A preliminary study of shear wave elastography for detecting early damage to cartilage in hemophiliac knee arthropathy |
| Changjingxuan,yujing,guojie,duliang,zhangcuiming |
| () |
| Abstract: |
| Objective: To investigate the value of shear wave elastography (SWE) in the detection of early damage to knee cartilage in patients with hemophiliac arthropathy, with the aim of providing a new examination method for early damage to knee cartilage in patients with hemophiliac arthropathy. Methods: Twenty-six male hemophilia A patients with recurrent bleeding in the knee joints and 30 male healthy volunteers matched for age, height and weight who visited our hospital from June 2022 to November 2023 were selected as study subjects. Routine two-dimensional ultrasonography was performed on the knee joints of both groups to obtain the cartilage thickness values of different parts of the knee joints and HEAD-US-C scores; further SWE examination of the knee cartilage was performed to obtain its Young's modulus values and shear wave velocity values. To analyze whether there was a statistical difference between cartilage thickness, Young's modulus value, and shear wave propagation velocity in different parts of the knee joint between the two groups. The patients with mild, moderate and severe hemophilia were stratified to analyze whether the measured parameters were statistically different. To statistically determine whether there was a correlation between HEAD-US-C scores and Young's modulus and shear wave velocity of cartilage in different parts of the knee joint in the case group of patients. Results: (1) The difference in cartilage thickness in different parts of the knee joint between the case group and the control group was statistically significant in a two-by-two comparison (P < 0.05), and the difference in Young's modulus and shear wave propagation velocity of the intercondylar and lateral condylar cartilage in a two-by-two comparison was statistically significant in a two-by-two comparison between the case group and the control group (P < 0.05).(2) There was no statistically significant difference in the thickness of the cartilage in different parts of the knee joint in a two-by-two comparison of the patients in the mild, moderate, and severe case groups (P>0.05). Young's modulus and shear wave propagation velocity of the intercondylar and lateral condylar cartilage of the knee joints of patients with hemophiliac arthropathy were compared among the three groups of mild, moderate, and severe cases, and except for the statistically insignificant difference between the moderate group and the severe group (P>0.05), the differences of the other parameters were statistically significant in a two-by-two comparison among the three groups (P<0.05). (3) There was a negative correlation between Young's modulus of knee cartilage, shear wave velocity and HEAD-US-C score of the patients in the case group, implying that the stiffness of knee cartilage of the patients in the case group decreased with the increase of the score. Conclusion:SWE can quantitatively measure the changes in the stiffness of knee cartilage, and can be more sensitive than conventional ultrasound in detecting early damage to cartilage in patients with hemophiliac arthropathy. |
| Key words: hemophiliac arthropathy Shear wave elastic imaging Knee cartilage HEAD-US-C score |
