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以經皮超音波剪向波彈性影像測量舌部組織硬度

Transcutaneous Ultrasound Shear Wave Elastography for Measurement of the Tongue Tissue Stiffness

摘要


背景:超音波彈性影像可客觀測量組織硬度,已被應用於肝臟、乳房及頭頸部腫瘤之輔助診斷,本描述性研究之目的在於探討以經皮超音波剪向波彈性影像(shear wave elastography, SWE)評估舌部組織硬度之可行性。方法:共20名無打鼾及睡眠呼吸中止症病史之健康受試者,仰臥接受舌部超音波彈性影像檢查,探頭置於下顎骨與舌骨間的正中線矢狀平面,比較正常呼吸時及Mueller maneuver時,舌部組織硬度的差異。結果:共10名女性,10名男性納入研究,平均年齡39.3±11.8歲,平均BMI為22.3±2.9 kg/m^2,平均Epworth嗜睡量表分數為2.5±2.0,所有受試者接受檢查後均無任何不適。正常呼吸時舌部組織剪向波彈性模數(shear wave modulus)在舌全區、舌前、中、後區分別爲21.5±8.1,21.2±8.7,18.4±7.2及24.9±12.3 kilopascals(kPa),Mueller Maneuver時分別爲21.6±10.1,21.4±13.2,21.7±15.5及21.7±9.3 kPa,以Wilcoxon signed-rank test檢定兩者間無顯著差異。進一步以Mann-Whitney U test比較不同性別舌部組織剪向波彈性模數,則不論在正常呼吸時或Mueller Maneuver時均無顯著差異。結論:超音波SWE可應用於客觀測量舌部組織硬度,未來可應用於舌部病變或阻塞性睡眠呼吸中止症患者舌部組織硬度之評估。

並列摘要


BACKGROUND: Ultrasound elastography, a technique for objectively measuring tissue stiffness, has recently been used in assisting diagnosis of liver, breast, and head and neck neoplasms. This descriptive study aims to investigate the feasibility of evaluating tongue tissue stiffness with transcutaneous ultrasound shear wave elastography. METHODS: Twenty healthy individuals without a history of snoring or obstructive sleep apnea participated in the study. All subjects were scanned in the supine position. The transducer was placed in the submental midline sagittal plane between the mandible and hyoid bone. We compared the tongue stiffness during normal breathing and Mueller Maneuver. RESULTS: Ten women and ten men were enrolled in the study (mean age 39.3 ± 11.8 years, mean body mass index 22.3 ± 2.9 kg/m^2, mean Epworth sleepiness scale 2.5 ± 2.0). All subjects reported no discomfort during the ultrasound examination. The shear wave modulus (in kilopascals, kPa) of the entire tongue and the anterior, middle, and posterior third of the tongue during normal breathing and during Mueller Maneuver was 21.5 ± 8.1, 21.2 ± 8.7, 18.4 ± 7.2, 24.9 ± 12.3 and 21.6 ± 10.1, 21.4 ± 13.2, 21.7 ± 15.5, 21.7 ± 9.3, respectively. A Wilcoxon signed-rank test demonstrated no significant difference between the two measurements. Subsequent comparison of the shear wave modulus between different genders using Mann-Whitney U test also revealed no significant difference. CONCLUSION: Ultrasound shear wave elastography is feasible in measuring the tissue stiffness of the tongue. Future applications of this technique involve an evaluation of the tongue pathology and an assessment of tongue tissue stiffness in patients with obstructive sleep apnea.

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