骨骼肌超声诊断迈向人工智能新领域:计算机辅助骨骼肌损伤超声定量诊断

骨骼肌损伤是临床常见问题，近年频发的自然灾害引发的严重肌肉损伤致伤致残率明显增高，及时诊断和准确评估肌肉损伤的范围和严重程度至关重要。肌肉受损后结构紊乱、境界模糊，而修复期纹理结构逐渐清晰。通过高分辨率超声可动态观察骨骼肌病理变化，其纹理成像效果不逊于磁共振成像，且具有独特的影像优势。但不同技术级别超声医师单独进行定性诊断时具有主观局限性，目前临床对于肌肉损伤尚未形成统一的超声定量诊断标准。本中心近年开展了一系列实验研究和初步临床实践，尝试运用骨骼肌超声图像计算机纹理分析技术研究肌肉损伤修复不同时期的超声影像表现，定量探讨损伤及修复期声像图上肌束纹理特征变化，运用超声造影观察伤肢肌肉动脉期血管分布特征演变，并从组织病理学角度对照观察损伤及修复期的肌纤维结构和胶原分布特点、血管化程度与其排列分布。相关研究有望为今后临床寻找定量、客观的骨骼肌损伤超声诊断评价指标提供理论依据。
Skeletal muscle injuries are common in clinic, and the rate of disability caused by frequent natural disasters is increasing in recent years. Prompt diagnosis and accurate assessment of the damage range and severity are critical when a muscular injury occurs. According to our emergency ultrasound experiences, structural disorder and textural changes of damaged thigh muscle of the crush syndrome patients can be dynamically observed by high resolution ultrasound, which has similar texture imaging effect compared with magnetic resonance imaging and has unique imaging advantages. However, visual evaluation of ultrasonograms depends more on the experiences of the ultrasonographers, and thus is quite subjecitve. Besides, there is no unified standard for quantitative diagnosis of injuried muscle by ultrasound. In order to provide references for quantitative evaluation of injured muscle pathology, we performed a series of in vitro experiments, animal experiments and preliminary clinical studies, and used computer-aided ultrasonsographic texture analysis to quantitatively evaluate the texture changes of skeletal muscle in different periods. We used contrast-enhanced ultrasound to observe the vascular distribution characteristics of skeletal muscles, and compared the muscle fiber structure, collagen distribution, and the degree of vascularization and vascular distribution in different periods, hoping to make quantitative muscle ultrasound as a practical and reliable tool for the muscle injury diagnosis