以經皮超音波剪向波彈性影像測量側咽壁組織硬度

背景：因超音波彈性影像技術可客觀測量組織硬度，已被應用於頭頸部腫瘤之輔助診斷及成人阻塞性睡眠呼吸中止症患者之舌部組織硬度評估。本先導研究之目的在探討以經皮超音波剪向波彈性之影像評估側咽壁組織硬度之可行性。方法：共22名無打鼾及阻塞性睡眠呼吸中止症之健康受試者參與研究，仰臥接受側頸部超音波彈性影像檢查，探頭縱向置於頸部側面枕骨下方，測量並記錄超音波影像中內頸動脈內側緣與側咽壁內表面之間的最大距離與剪向波彈性模數（shear modulus），並比較男性及女性受測者側咽壁厚度及組織硬度。結果：共11名女性及11名男性納入研究，平均年齡33.5±9.0歲（21－59歲），平均BMI為23.4±2.8kg/m^2，平均Epworth嗜睡量表分數為6.0±5.0，所有受試者接受檢查後無任何不適。超音波側咽壁厚度在不同性別間之比較並無顯著差異（P=0.309），女性和男性的平均側咽壁組織剪向波彈性模數分別為24.2±9.1和21.9±7.4 kilopascals（kPa），以Mann－Whitney U test檢定兩者間無顯著差異（P=0.441），但男性之側咽頸部厚度明顯大於女性（P=0.022），所有受試者平均舌部組織剪向波彈性模數較側咽壁為高（25.0±7.0 vs 23.1±8.2 kPa），但無統計學上顯著的差異（P=0.367）。結論：超音波剪向波彈性影像檢查可應用於客觀測量舌部及側咽壁組織硬度，未來可應用於側咽壁組織病變或阻塞性睡眠呼吸中止症患者側咽壁組織硬度之評估。

關鍵字

elastography ； lateral pharyngeal wall ； shear modulus ； tissue stiffness ； ultrasound（彈性影像；側咽壁；剪向波彈性模數；組織硬度；超音波）

並列摘要

BACKGROUND: Ultrasound elastography is a technique for objectively measuring tissue stiffness that has been used in assisting the diagnosis of head and neck neoplasms and the evaluation of tongue stiffness in adult patients with obstructive sleep apnea. This pilot study investigated the feasibility of evaluating lateral pharyngeal wall (LPW) tissue stiffness by using transcutaneous ultrasound shear wave elastography. METHOD: Healthy individuals (n = 22) without a history of snoring or obstructive sleep apnea participated in the study. All participants were scanned in the supine position. The transducer was placed longitudinally on the lateral side of the neck, just inferior to the occiput. The maximum distance and shear modulus between the inner margin of the internal carotid artery and the inner surface of the LPW were recorded and measured using ultrasound images. We compared LPW thickness and tissue stiffness between men and women. RESULTS: A total of 11 women and 11 men were enrolled in the study (mean age 33.5 ± 9.0 years, range: 21-59 years, mean body mass index: 23.4 ± 2.8 kg/m^2, mean Epworth sleepiness scale score: 6.0 ± 5.0). All participants reported no discomfort during the ultrasound examination. A comparison between the sexes of LPW thickness through ultrasonography revealed no significant difference (P = 0.309). The shear moduli (in kilopascals) of the LPW in women and men was 24.2 ± 9.1 and 21.9 ± 7.4, respectively. A Mann-Whitney U test indicated no significant differences between the two ultrasonographic measurements (P = 0.441). However, parapharyngeal neck thickness was significantly higher in men than in women subjects (P = 0.022). The mean ultrasound shear modulus of the tongue of all participants was higher than that of the LPW (25.0 ± 7.0 vs. 23.1 ± 8.2 kPa); however, the difference was not statistically significant (P = 0.367). CONCLUSIONS: Ultrasound shear wave elastography is a feasible means of measuring the tissue stiffness of the tongue and the LPW. This technique could be applied in the evaluation of the LPW pathology and the assessment of tissue stiffness in patients with obstructive sleep apnea.

並列關鍵字

elastography ； lateral pharyngeal wall ； shear modulus ； tissue stiffness ； ultrasound

國際替代計量

以經皮超音波剪向波彈性影像測量側咽壁組織硬度

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