Objective To explore the clinical value of shear wave elastography in the evaluation of quadriceps femoris lesions in patients with chronic obstructive pulmonary disease (COPD). Methods Fifty-eight COPD patients who were admitted to Chengdu First People’s Hospital and 55 healthy controls were included in the study between August 2021 and February 2022. The thickness, circumference, cross-sectional area and Young's modulus of quadriceps femoris in all subjects were measured using shear wave elastography combined with conventional two-dimensional ultrasound. The differences in ultrasound parameters between the two groups were compared, and the correlation between each ultrasound parameter and clinical evaluation indicators (modified British Medical Research Council Scale, COPD Assessment Test, six-minute walk test, and five-time sit-to-stand test) was analyzed. Results Young’s modulus values of the quadriceps femoris muscle were smaller in the COPD group than those in the healthy control group [COPD Group: rectus femoris 6.72 (6.22, 7.36) kPa, vastus medialis 6.25 (5.82, 6.79) kPa, vastus lateralis 6.94 (6.17, 7.48) kPa; healthy control group: rectus femoris 11.40 (10.23, 12.11) kPa, vastus medialis 10.77 (9.62, 11.42) kPa, vastus lateralis 11.14 (10.42, 12.52) kPa]. The differences were statistically significant (all P<0.05). The Young's modulus value of the rectus femoris muscle correlates with the aforementioned clinical evaluation indicators, with positive correlation with six-minute walk distance and negative correlation with COPD Assessment Test, modified British Medical Research Council Scale, five-time sit-to-stand time (P<0.05). Quadriceps thickness, circumference, and cross-sectional area measured by conventional two-dimensional ultrasound were not significantly different between the two groups, nor were there significant correlations between each parameter and clinical parameters (P>0.05). In addition, shear wave elastography has good reproducibility in the measurement of Young's modulus in quadriceps. Conclusions Shear wave elastography can identify quadriceps lesions earlier than conventional two-dimensional ultrasound in COPD patients, and there is a significant correlation between its measurements and the clinical condition of COPD patients. Shear wave elastography may provide a simple and noninvasive method for clinical evaluation of quadriceps femoris lesions in COPD patients.
Objective To explore the feasibility of transluminal dual plane ultrasound (TDPU) in evaluating the structure and function of pelvic floor muscle. Methods Non anorectal diseases patients who visited the Department of Medical Ultrasound, West China Hospital of Sichuan University, medical staff and medical staff’s relatives volunteers between May and November 2022 were selected. According to the criteria for ultrasound diagnosis of pelvic organ prolapse (POP) and the pelvic organ prolapse quantification (POP-Q) scoring criteria, the subjects were divided into normal group and POP group. The changes of the thickness of the left and right puborectalis muscle (PRM), the internal anal sphincter (IAS) and the external anal sphincter (EAS) at 3-, 6- and 9-o’clock, the depth and height of the perineal body (PB) were compared, and the changes of the elastic Young’s modulus of PRM, EAS and PB were compared through real-time shear wave elastography. Results A total of 192 subjects were included, including 140 in the normal group and 52 in the POP group. There were statistically significant differences between the POP group and the normal group in terms of gestational frequency, parity, and history of vaginal delivery (P<0.05). There was no statistically significant difference in age, body mass index, menopausal history, and neonatal weight between the two groups (P>0.05). Under the condition of resting and maximum anal constriction, the thickness of PRM on the left and right sides of POP group was not significantly different from that of the normal group (P>0.05), but the elastic Young’s modulus of PRM on the left and right sides were lower than that of the normal group (P<0.05). At resting and maximum anal constriction, there was no significant difference in IAS thickness between the POP group and the normal group at 3-, 6- and 9-o’clock (P>0.05). At resting and maximum anal constriction, the thickness of deep and subcutaneous parts of EAS at 6-o’clock and the subcutaneous part of EAS at 9-o’clock in the POP group were smaller than those in the normal group (P<0.05). At resting and maximum anal constriction, the elastic Young’s modulus of EAS at 3-, 6- and 9-o’clock were lower than those in the normal group (P<0.05). There was no significant difference in the depth and height of PB between the POP group and the normal group at resting and maximum anal constriction (P>0.05). The elastic Young’s modulus of PB in the POP group was lower than that of the normal group (P<0.05). Under the condition of maximum anal constriction, the thickness of deep and subcutaneous parts of EAS at 3-o’clock in the POP group were lower than those in the normal group (P<0.05). Conclusion TDPU can quantitatively evaluate the structure and function of pelvic floor muscle through different states of resting and maximum anal constriction, and also can provide ultrasonic basis for the diagnosis and treatment of female pelvic floor dysfunction diseases.