高频超声测量掌指关节软骨厚度稳定性的影响因素
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摘要
目的探讨影响第2掌指关节(MCP2)软骨厚度(CTh)高频超声测量结果稳定性的因素。方法对120名健康志愿者分别由不同操作者于不同时间、仪器、参数(频率、增益)及测量时包含或不包含软骨上方亮线(BL)条件下测量右侧MCP2的CTh,并进行统计学分析。结果包含和不包含BL测量时,右侧MCP2的CTh分别为(0.50±0.09)mm和(0.38±0.09)mm,差异有统计学意义(t=-18.528,P<0.001),二者的变异系数分别为4.44%和5.78%。相同仪器及参数条件下,不同操作者及不同时间,无论包含或不包含BL的测量结果间差异均无统计学意义(P均>0.05)。同一操作者相同参数条件下,采用不同仪器测量时,包含或不包含BL的测量结果间差异均有统计学差异(P均<0.05)。同一操作者相同仪器条件下,采用不同参数测量结果显示,仅相同频率、不同增益条件下不包含BL的测量结果间差异有统计学意义(P<0.05)。无论包含或不包含BL,不同操作者、时间、仪器、参数条件下测量结果间均存在相关性(P均<0.01)。包含BL的测量结果显示,相关系数在不同仪器条件下最小(r=0.619),不同增益条件下最大(r=0.820)。结论高频超声测量右侧MCP2的CTh时,包含BL较不包含BL的测量结果更稳定。更换超声仪器对测量结果的影响最大,增益变化对测量结果的影响较小。
Objective To investigate the impact factors of stability of high-frequency ultrasound in measurement of cartilage thickness(CTh)of the second metacarpophalangeal joint(MCP2).Methods Under the conditions of different operator,time,instrument,parameters(frequency and gain)and whether including the bright line(BL)above cartilage or not,CTh of the right MCP2 in 120healthy volunteers were measured with high-frequency ultrasound.Then statistical analysis was performed.Results CTh of the right MCP2 was(0.50±0.09)mm including BL and(0.38±0.09)mm excluding BL,respectively(t=-18.528,P<0.001),and the variable coefficient was 4.44% and 5.78%,respectively.Under the same instrument and parameters,there was no statistical difference between the measurement results of different operators and time,whether including BL or not(all P>0.05).Under the same operator and parameters,there were statistical differences between the measurement results of different instrument,whether including BL or not(both P<0.05).Under the same operator and instrument,there were statistical differences between the measurement results of excluding BL with variable gain and stable frequency(P<0.05).Whether including BL or not,there were correlations between the measurement results of different operator,time,instrument and parameters(all P<0.01).The measurement results including BL showed that the correlation was slight between different instrument(r=0.619)but obvious between different gain(r=0.820),respectively.Conclusion High-frequency ultrasound measurement results of the right MCP2 CTh including BL are more stable than those excluding BL.Instrument has great influence on measurement results,while gain has little effect for measurement.
Objective To investigate the impact factors of stability of high-frequency ultrasound in measurement of cartilage thickness(CTh)of the second metacarpophalangeal joint(MCP2).Methods Under the conditions of different operator,time,instrument,parameters(frequency and gain)and whether including the bright line(BL)above cartilage or not,CTh of the right MCP2 in 120healthy volunteers were measured with high-frequency ultrasound.Then statistical analysis was performed.Results CTh of the right MCP2 was(0.50±0.09)mm including BL and(0.38±0.09)mm excluding BL,respectively(t=-18.528,P<0.001),and the variable coefficient was 4.44% and 5.78%,respectively.Under the same instrument and parameters,there was no statistical difference between the measurement results of different operators and time,whether including BL or not(all P>0.05).Under the same operator and parameters,there were statistical differences between the measurement results of different instrument,whether including BL or not(both P<0.05).Under the same operator and instrument,there were statistical differences between the measurement results of excluding BL with variable gain and stable frequency(P<0.05).Whether including BL or not,there were correlations between the measurement results of different operator,time,instrument and parameters(all P<0.01).The measurement results including BL showed that the correlation was slight between different instrument(r=0.619)but obvious between different gain(r=0.820),respectively.Conclusion High-frequency ultrasound measurement results of the right MCP2 CTh including BL are more stable than those excluding BL.Instrument has great influence on measurement results,while gain has little effect for measurement.
引文
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[2]张晓慧,邓雪蓉,耿研,等.中国膝骨关节炎患者超声表现.中华风湿病学杂志,2016,20(9):604-608.
[3] Bruyn GA,Naredo E,Iagnocco A,et al.The OMERACT ultrasound working group 10years on:Update at OMERACT12.J Rheumatol,2015,42(11):2172-2176.
[4] Terslev L, Gutierrez M, Christensen R,et al. Assessing elementary lesions in gout by ultrasound:Results of an OMERACT patient-based agreement and reliability exercise.J Rheumatol,2015,42(11):2149-2154.
[5] Filippou G,ScirèCA, Damjanov N,et al. Definition and reliability assessment of elementary ultrasonographic findings in calcium pyrophosphate deposition disease:A study by the OMERACT calcium pyrophosphate deposition disease ultrasound subtask force.J Rheumatol,2017,44(11):1744-1749.
[6] Salaffi F, Gutierrez M, Carotti M. Ultrasound versus conventional radiography in the assessment of bone erosions in rheumatoid arthritis.Clin Exp Rheumatol,2014,32(1):S85-S90.
[7] Hermann KG,Backhaus M,Schneider U,et al.Rheumatoid arthritis of the shoulder joint:Comparison of conventional radiography, ultrasound, anddynamiccontrast-enhanced magnetic resonance imaging.Arthritis Rheum,2003,48(12):3338-3349.
[8] Chen DY,Lan HC,Lai KL,et al.Diagnostic utility of US for detecting rotator cuff tears in rheumatoid arthritis patients:Comparison with magnetic resonance imaging.J Med Ultrasound,2014,22(4):200-206.
[9]徐愿,宿峰,陶庆文,等.类风湿关节炎患者掌指关节2,3与掌指关节1,4,5超声表现的比较研究.中日友好医院学报,2014,28(6):323-325.
[10] Wakefield RJ,Gibbon WW,Conaghan PG,et al.The value of sonography in the detection of bone erosions in patients with rheumatoidarthritis:Acomparisonwithconventional radiography.Arthritis Rheum,2000,43(43):2762-2770.
[11] M9ller B,Bonel H,Rotzetter M,et al.Measuring finger joint cartilage by ultrasound as a promising alternative to conventional radiograph imaging.Arthritis Rheum,2009,61(4):435-441.