Comparison of shear wave elastic imaging technique for elastic modulus of shoulder girdle muscles in healthy adults and patients with scapular dyskinesis
Jiang Qianru1, Guo Yi2, Cui Zhigang1,3, Liu Sihai1,3, Han Xinzuo1,3, Li Xuemei2, Liu Kemin1,3
1Capital Medical University School of Rehabilitation Medicine, Beijing 100068,China; 2Department of Ultrasound, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China; 3Department of Orthopedics and Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
Abstract：Objective This study aims to explore the application value of quantitatively evaluating and comparing the elastic modulus of shoulder girdle muscles between healthy adults and patients with scapular dyskinesis by using shear wave elastography (SWE).Methods A case-control study was conducted. From Mar 2019 to Sep 2019, 33 patients (33 shoulders) with scapular dyskinesis(SD) including 10 males and 23 females aged 35 to 71 years from China Rehabilitation Research Center were selected into SD group. In the same period, 32 healthy volunteers (61 shoulders) including 10 males and 22 females aged from 22 to 74 years were also recruited as control group. Thickness, shear wave velocity of upper trapezius (UT), levator scapulae (LS), middle trapezius (MT), rhomboid (RM), lower trapezius (LT), and serratus anterior (SA) were measured with 2-D ultrasound and SWE. Elastic modulus was calculated. Thickness and elastic modulus of shoulder girdle muscles were compared between SD and control groups, and the effects of age and sex on thickness and elastic modulus of shoulder girdle muscles were analyzed.Results Patients with SD had higher elastic modulus of UT, UT/MT, UT/LT(44.42±29.17) kPa (1 mmHg=0.133 kPa), 1.59±0.56, and 1.56±0.63 than healthy adults (31.00±12.68) kPa, 1.30±0.30, and 1.30±0.30, but had lower thickness of LS (0.40±0.11) cm than healthy adults (0.47±0.17) cm, and the differences were statistically significant (all P values < 0.05). The elastic modulus of RM in young patients with SD (31.14±3.93 )kPa was higher than that of young healthy adults (23.30±8.24) kPa. The UT/SA in middle-aged patients with SD (1.57±0.38) was greater than that of middle-aged healthy adults (1.30±0.33). Moreover, the UT/MT, the elastic modulus of UT, LS, and SA in elderly patients with SD [1.81±0.68, (53.59±36.99) kPa, (36.54±11.41) kPa, (18.51±8.05) kPa] were greater than those of elderly healthy adults [1.40±0.39, (32.01±11.93) kPa, (28.82±9.42) kPa, (13.04±7.23) kPa]. The differences were statistically significant (all P values<0.05). Among the 32 healthy adults and 33 patients with SD, SA was significantly thicker in males [(0.82±0.24) cm and (0.80±0.17) cm] than in females[ (0.63±0.15) cm and (0.69±0.17 )cm]. Furthermore, the elastic modulus of UT was greater in females[(32.91±13.87) kPa than in males (26.77±8.37) kPa], and the difference was statistically significant (all P values<0.05). Among the 32 healthy adults, SA thickness, elastic modulus of LT, and SA were negatively associated with age (r=-0.334, -0.416, -0.431). UT/LT and UT/SA were positively associated with age (r=0.317, 0.300). Among the 33 patients with SD, UT/MT and elastic modulus of LS were positively associated with age (r=0.410, 0.399). However, the elastic modulus of RM was negatively associated with age (r=-0.317, -0.300), and the difference was statistically significant (all P values<0.05).Conclusions SWE can be used to quantify the elastic modulus of shoulder girdle muscles and can reflect the characteristics of imbalance of scapular muscle couple in patients with SD. This work provides certain guiding significance for prevention, early diagnosis, and precision rehabilitation of SD.
蒋倩如, 郭忆, 崔志刚, 刘四海, 韩新祚, 李雪梅, 刘克敏. 剪切波弹性成像技术评估肩胛动力障碍患者和健康成人肩胛带肌厚度与弹性模量的对比研究[J]. 中华解剖与临床杂志, 2020, 25(5): 491-497.
Jiang Qianru, Guo Yi, Cui Zhigang, Liu Sihai, Han Xinzuo, Li Xuemei, Liu Kemin. Comparison of shear wave elastic imaging technique for elastic modulus of shoulder girdle muscles in healthy adults and patients with scapular dyskinesis. Chinese Journal of Anatomy and Clinics, 2020, 25(5): 491-497.
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