超声射频信号定量分析发现关节软骨退行性变的可行性研究
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摘要
目的探讨基于超声射频信号的多参数定量分析诊断股骨滑车软骨退行性变的可行性。方法选取行膝关节镜检查的患者58人60例膝关节,术前采集股骨滑车软骨的射频信号及高频超声灰阶图像,以关节镜为金标准判断滑车软骨是否退变并分为病例组和对照组。分别提取股骨滑车软骨区域10个参数进行统计学分析。同时利用常规高频超声灰阶图像进行诊断。结果其中,上边界粗糙度(URI_ant)、上边界反射强度、上边界反射均匀度及上边界和内部回波对比度在病例组与对照组间有统计学差异(P<0.01),其中应用ROC曲线以URI_ant为8.45为截断值判定软骨退变的AUC最大,灵敏性和特异性分别为72.5%和95.0%,常规高频超声的灵敏性和特异性分别为67.5%和80.0%。结论利用基于超声射频信号的多个参数定量评估股骨滑车软骨的退行性变具有可行性,且优于常规高频灰阶超声。
Objective To investigate the feasibility of quantitative assessment based on ultrasound radio frequency(RF) signal in diagnosis of femoral trochlear cartilage degeneration in vivo. Methods A total of 58 patients, 60 cases of knee arthroscopy were enrolled in this study. Radio frequency signals and high-frequency ultrasound gray-scale images of trochlear cartilage were collected before the operations. Arthroscopy was used as the gold standard to determine whether the trochlear cartilage was degenerative, and the patients were divided into case group and control group. Ten parameters of the cartilage region of the trochlear femur were extracted for statistical analysis. Gray-scale ultrasound images were also collected for diagnosis. Results ultrasound roughness index of anterior surface(URI_ant), re?ection coefficient of anterior surface, spatial variation of US re?ection coefficient and contrast of re?ection coefficient between anterior surface and interior cartilage were different between the case group and control group(P<0.01). The application of ROC curve for URI_ant 8.45 cutoff value to determine the largest AUC of cartilage degeneration, sensitivity and specificity were 72.5% and 95.0%, respectively. Conventional high frequency ultrasonic sensitivity and specificity of 67.5% and 80.0 %, respectively. Conclusion It is feasible to quantitatively evaluate the degeneration of femoral trochlear cartilage using multiple parameters based on ultrasonic radiofrequency signal, and it is better than conventional grayscale ultrasound.
Objective To investigate the feasibility of quantitative assessment based on ultrasound radio frequency(RF) signal in diagnosis of femoral trochlear cartilage degeneration in vivo. Methods A total of 58 patients, 60 cases of knee arthroscopy were enrolled in this study. Radio frequency signals and high-frequency ultrasound gray-scale images of trochlear cartilage were collected before the operations. Arthroscopy was used as the gold standard to determine whether the trochlear cartilage was degenerative, and the patients were divided into case group and control group. Ten parameters of the cartilage region of the trochlear femur were extracted for statistical analysis. Gray-scale ultrasound images were also collected for diagnosis. Results ultrasound roughness index of anterior surface(URI_ant), re?ection coefficient of anterior surface, spatial variation of US re?ection coefficient and contrast of re?ection coefficient between anterior surface and interior cartilage were different between the case group and control group(P<0.01). The application of ROC curve for URI_ant 8.45 cutoff value to determine the largest AUC of cartilage degeneration, sensitivity and specificity were 72.5% and 95.0%, respectively. Conventional high frequency ultrasonic sensitivity and specificity of 67.5% and 80.0 %, respectively. Conclusion It is feasible to quantitatively evaluate the degeneration of femoral trochlear cartilage using multiple parameters based on ultrasonic radiofrequency signal, and it is better than conventional grayscale ultrasound.
引文
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[14]Saarakkala S,T?yr?s J,Hirvonen J,et al.Ultrasonic quantitation of superficial degradation of articular cartilage[J].Ultrasound Med Biol,2004,30(6):783-792.
[15]沙雷亚尔.O'Connor关节镜外科学[M].上海:复旦大学出版社,2001.
[16]Goldring M,Goldring S.O steoarthritis[J].J Cell Physiol,2007,213(3):626-634.
[17]Zhang J,Chen S,Chen W,et al.Ultrastructural change of the subchondral bone increases the severity of cartilage damage in osteoporotic osteoarthritis of the knee in rabbits[J].Pathol Res Pract,2018,214(1):38-43.
[18]Fell N,Lawless B,Cox S,et al.The role of subchondral bone,a nd its histomorphology,on the dynamic viscoelasticity of cartilage,bone and osteochondral cores[J].Osteoarthr Cartil,2019,27(3):535-543.
[2]Hurtig M,Chubinskaya S,Dickey J,et al.BMP-7 protects against progression of cartilage degeneration after impact injury[J].JOrthop Res,2009,27(5):602-611.
[3]Saarakkala S,Waris P,Waris V,et al.Diagnostic performance of knee ultrasonography for detecting degenerative changes of articular cartilage[J].Ultrasound Q,2012,20(5):376-381.
[4]Nieminen HJ,Zheng Y,Saarakkala S,et al.Quantitative assessment of articular cartilage using high-frequency ultrasound:research findings and diagnostic prospects[J].Crit Rev Biomed Eng,2009,37(6):461.
[5]严郁,朱伟,竺明月,等.基于MATLAB的超声射频信号成像重建设计[J].中国医疗设备,2018,33(8):86-88.
[6]Wataru K,Yasuaki N,Akira I,et al.Ultrasound parameters for human osteoarthritic subchondral bone,ex vivo:comparison with micro-computed tomography parameters[J].Ultrasound Med Biol,2018:S0301562918302369.
[7]Wang Q,Liu Z,Wang Y,et al.Quantitative ultrasound assessment of cartilage degeneration in ovariectomized rats with low estrogen levels[J].Ultrasound Med Biol,2016,42(1):290.
[8]Zhang J,Xiao L,Tong L,et al.Quantitative evaluation of enzyme-induced porcine articular cartilage degeneration based on observation of entire cartilage layer using ultrasound[J].Ultrasound Med Biol,2018:S0301562917324602.
[9]Madry H,Luyten FP,Facchini A.Biological aspects of early osteoarthritis[J].Knee Surg Sport Tra,2012,20(3):407-422.
[10]Pritzker KPH,Gay S,Jimenez SA,et al.Osteoarthritis cartilage histopathology:grading and staging[J].Osteoar Cart2006,14(1):13-29.
[11]M?nnicke N,Sch?ne M,Oelze M,et al.Articular cartilage degeneration classification by means of high-frequency ultrasound[J].Osteoarthr Cartil,2014,22(10):1577-1582.
[12]Niu HJ,Wang Q,Wang YX,et al.Ultrasonic reflection coefficient and surface roughness index of OA articular cartilage:Relation to pathological assessment[J].BMC Muscul Disord,2012,13(1):34.
[13]Kiyan W,Ito A,Nakagawa Y,et al.Relationships between quantitative pulse-echo ultrasound parameters from the superficial zone of the human articular cartilage and changes in surface roughness,collagen content or collagen orientation caused by early degeneration[J].Ultrasound Med Biol,2017,43(8):1703-1715.
[14]Saarakkala S,T?yr?s J,Hirvonen J,et al.Ultrasonic quantitation of superficial degradation of articular cartilage[J].Ultrasound Med Biol,2004,30(6):783-792.
[15]沙雷亚尔.O'Connor关节镜外科学[M].上海:复旦大学出版社,2001.
[16]Goldring M,Goldring S.O steoarthritis[J].J Cell Physiol,2007,213(3):626-634.
[17]Zhang J,Chen S,Chen W,et al.Ultrastructural change of the subchondral bone increases the severity of cartilage damage in osteoporotic osteoarthritis of the knee in rabbits[J].Pathol Res Pract,2018,214(1):38-43.
[18]Fell N,Lawless B,Cox S,et al.The role of subchondral bone,a nd its histomorphology,on the dynamic viscoelasticity of cartilage,bone and osteochondral cores[J].Osteoarthr Cartil,2019,27(3):535-543.