A preliminary clinical study of shear wave elastography in evaluating early degeneration of knee articular cartilage
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摘要:
目的初步探讨剪切波弹性成像技术（SWE）对早期膝关节骨性关节炎患者关节软骨的影响及其临床价值。 方法分别选取20例健康成年人和20例早期膝关节骨性关节炎患者作为研究对象，进行常规及SWE检查，测量内容包括髁间区、内侧髁软骨厚度及杨氏模量，对组内、组间软骨厚度及杨氏模量是否存在统计学差异进行分析。 结果试验组髁间区、内侧髁、对照组髁间区、内侧髁软骨厚度分别为0.225±0.025、0.217±0.026、0.235±0.023、0.209±0.019 mm，组内不同部位两两比较差异有统计学意义（P < 0.05）；组间相同部位两两比较差异无统计学意义（P > 0.05）；试验组髁间区、内侧髁、对照组髁间区、内侧髁软骨杨氏模量分别为24.17±3.85、25.94±3.55、19.93±2.69、21.59±2.57 kPa，组内不同部位两两比较差异有统计学意义（P < 0.05）；组间相同部位两两比较差异无统计学意义（P > 0.05）。 结论SWE可以定量评价体内膝关节软骨的力学性能，早期膝关节骨性关节炎患者膝关节髁间区及内侧髁软骨杨氏模量均大于正常人群。 Abstract:ObjectiveTo explore the effect and its clinical value of shear wave elastography (SWE) preliminarily on articular cartilage in patients with early knee osteoarthritis (KOA). Methods20 healthy adults and 20 early knee osteoarthritis patients who met the enrollment criteria were selected as the research objects. Routine and shear wave elastography examinations were performed. The thickness and Young's modulus of the intercondylar and medial condyle cartilage were included. The thickness and Young's modulus of cartilage within and between groups were analyzed for statistical differences. ResultsThe cartilage thickness of the intercondylar area, medial condyle in the test group were 0.225±0.025, 0.217±0.026, and those of the control group were 0.235±0.023 and 0.209±0.019 mm. There was statistically significant difference between different parts in the group (P < 0.05). There was no statistically significant difference in the same part between groups (P > 0.05). The cartilage Young's modulus of the intercondylar area, medial condyle in the test group and in the control group were 24.17±3.85, 25.94±3.55, 19.93± 2.69 and 21.59±2.57 kPa respectively. There was statistically significant difference in different parts within the group (P < 0.05). There was statistically significant difference in the same part between groups (P < 0.05). ConclusionSWE can quantitatively evaluate the mechanical properties of knee articular cartilage in vivo. The Young's modulus of intercondylar and medial condyle cartilage in early KOA patients is greater than that of the normal population. -
Key words:
- elastography /
- shear wave velocity /
- cartilage /
- osteoarthritis
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图 1 早期KOA患者髁间区软骨SWE图像
A: 测量髁间区软骨杨氏模量; B: 同一患者涂适量厚度耦合剂后图像
Figure 1. SWE image of cartilage in the intercondylar area of an earlyKOApatient.
表 1 两组不同部位软骨厚度与杨氏模量比较
Table 1. Comparison of cartilage thickness and Young's modulus in different parts of the two groups
指标 试验组 对照组 P Range Mean±SD Range Mean±SD 髁间区软骨厚度(mm) 0.181~0.270 0.225±0.025 0.184~0.276 0.235±0.023 0.179 内侧髁软骨厚度(mm) 0.184~0.261 0.217±0.026 0.173~0.242 0.209±0.019 0.321 P 0.001 0.000 髁间区软骨杨氏模量E（kPa） 18.80~32.59 24.17±3.85 16.05~26.75 19.93±2.69 0.000 内侧髁软骨杨氏模量E（kPa） 20.39~34.07 25.94±3.55 15.63~24.95 21.59±2.57 0.000 P 0.000 0.000 
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