摘要
目的探讨实时超声弹性成像(RTE)与能量多普勒(PDI)在不同病程2型糖尿病(T2DM)患者跟腱异常改变中的诊断价值。方法 135例T2DM患者根据病程分为A组(病程<5年)、B组(病程5~10年)及C组(病程>10年),每组各45例,均行RTE技术与PDI检查,获取各组诊断效能。以MRI检查结果为金标准,绘制受试者工作特征(ROC)曲线分析PDI和RTE对T2DM患者跟腱异常的诊断效能。结果 PDI检查显示,A组血流分级0级42例,Ⅰ级3例;诊断准确率84.44%,敏感性30.00%,特异性100%。B组血流分级0级39例,Ⅰ级5例,Ⅱ级1例;诊断准确率82.22%,敏感性42.86%,特异性100%。C组血流分级0级37例,Ⅰ级6例,Ⅱ级2例;诊断准确率80.00%,敏感性47.06%,特异性100%。RTE检查显示,A组弹性分级1级31例,2级6例,3级8例;诊断准确率95.56%,敏感性80.00%,特异性94.59%。B组弹性分级1级26例,2级7例,3级12例;诊断准确率95.56%,敏感性85.71%,特异性93.94%。C组弹性分级1级23例,2级7例,3级15例;诊断准确率95.56%,敏感性88.23%,特异性93.33%。A、B、C组应变率比值分别为2.79±0.60、3.58±1.15、4.39±1.37,各组两两比较差异均有统计学意义(均P<0.05)。ROC曲线分析显示,弹性成像分级法诊断T2DM患者跟腱异常的曲线下面积为0.927,高于应变率比值和PDI,差异均有统计学意义(Z=-6.018、-2.134,均P<0.05)。结论 RTE与PDI对T2DM患者跟腱异常改变均有一定诊断价值,但RTE价值较PDI更高。
Objective To explore the value of real-time ultrasonic elastography(RTE)and power Doppler(PDI)in the diagnosis of abnormal changes of achilles tendon in patients with different courses of type 2 diabetes(T2 DM).Methods According to the disease course,135 patients with T2 DM were divided into group A(disease course <5 years),group B(disease course 5~10 years),and group C(disease course> 10 years),with 45 cases in each group,all underwent RTE and PDI,the diagnostic efficacy was obtained.Taking the results of MRI as golden standard,receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of PDI and RTE for achilles tendon abnormalities in T2 DM patients.Results PDI showed that in group A,there were 42 cases of blood flow grade 0,3 cases of gradeⅠ,the diagnostic accuracy was 84.44%,the sensitivity was 30.00%,and the specificity was 100%.In group B,there were 39 cases of blood flow grade 0,5 cases of grade Ⅰ,1 case of grade Ⅱ,the diagnostic accuracy was 82.22%,the sensitivity was 42.86%,and the specificity was 100%.In group C,37 cases of blood flow grade 0,6 cases of grade Ⅰ,2 cases of grade Ⅱ,the diagnostic accuracy was 80.00%,the sensitivity was 47.06%,the specificity was 100%.RTE showed that in group A,there were 31 cases of elastography grade 1,6 cases of grade 2,and 8 cases of grade 3,the diagnostic accuracy was 95.56%,the sensitivity was 80.00%,and the specificity was 94.59%.In group B,there were 26 cases of elastography grade 1,7 cases of grade 2,and 12 cases of grade 3,the diagnostic accuracy was 95.56%,the sensitivity was 85.71%,and the specificity was 93.94%.In group C,there were 23 cases of elastography grade 1,7 cases of grade 2,15 cases of grade 3,the diagnostic accuracy was 95.56%,the sensitivity was 88.23%,and the specificity was 93.33%.The strain rate ratios of groups A,B,and C were 2.79±0.60,3.58±1.15,and 4.39±1.37,respectively,and the difference between each group were statistically significant(all P<0.05).ROC curve analysis showed that the area under the
作者
沈孔剑
盛静
肖美琴
刘兰
李平
SHEN Kongjian;SHENG Jing;XIAO Meiqin;LIU Lan;LI Ping(Department of Ultrasound,the Second People’s Hospital of Yuhuan City,Zhejiang 317605,China)
出处
《临床超声医学杂志》
CSCD
2021年第12期924-928,共5页
Journal of Clinical Ultrasound in Medicine
基金
成都中医药大学2020年度“杏林学者”医院专项基金项目(YYZX2020058)。
关键词
超声弹性成像
实时
能量多普勒
2型糖尿病
跟腱异常改变
Ultrasonic elastography,real-time
Power Doppler
Type 2 diabetes
Abnormal changes of achilles tendon
