臺灣博碩士論文加值系統

近期關於肌腱組織的研究，多數使用核磁共震以及超音波影像做評估，其缺點在於無法量化其機械特性；而本研究採用的定量式超音波(QUS)技術，廣泛應用於量化活體組織。利用超音波穿過組織時所擷取的寬頻波衰減(BUA)和波速(SOS)，重建成二維的影像方式表現，通常應用於骨密度的評估，但在軟組織的發展上，還處於一個剛起步的階段，不過對於非侵入式量測肌腱組織，是具有潛力的一種方法。
然而，至今仍無文獻清楚的討論BUA與SOS的參數與肌腱機械特性的相關性；有鑒於此，我們設計了一個定量式超音波與應變量測的肌腱測試系統，藉由拉伸的方式，呈現於活體時的肌腱運動情況，用來評估離體豬腱的特性。此外於系統上另裝置一個雷射測距機在旋轉機構上，經由連續量測來重建肌腱截面，觀察面積與超音波量測厚度的關係。結果顯示，施與拉升應力達400 N時，其截面積下降6.6 %；波衰減隨著應力上升，下降16.3%。而SOS則隨著肌腱兩端的拉伸而升高0.6%，不過由於個體差異大於其變化率，無法做出任何統計推論。BUA則是下降30%，但是樣本數僅有六筆，因為軟組織的高頻波衰減，不如硬組織(骨頭)明顯。最後結果顯示，QUS參數確實可以在非侵入的情況下，使用來量化阿基里斯腱的潛力。而在比較厚度的量測上，超音波的厚度量測與平均的面積具有高度相關性(R2=0.74)，也證實使用超音波來量測非均勻的軟組織厚度，可以提供較為客觀的結果。

MR imaging and sonography are two imaging modalities for diagnosing tendon and ligament in the present medical practice. However, disadvantage such as lacking quantitative mechanical properties remains for tendon. Quantitative ultrasound (QUS) technique has been widely applied on the characterization of human tissues, and evaluation of osteoporosis, by measuring wave propagating properties nearly becomes a screening test for measurement of bone density. Presently, utilizing QUS for evaluating the property of tendons is in an infant stage of development; Nevertheless, it has the potential to be a noninvasive method for examing human’s tendon.
In this report, we designed a stress-strain measurement system, combined with QUS technique, to measure the property of porcine tendon. In the beginning, a system for detecting cross-sectional area was designed for continuous measurement, using a laser triangulation displacement sensor mounted on a rotary. The results showed that the surface area, attenuation, and BUA all decreased along with the loading increased, and the area and attenuation reduced 6.6% when the loading was exactly 400 N. SOS increased along with the loading increased, but only raised 0.6% for loading of 400 N. However, statistic analysis showed the comparison was insignificance since the variance of SOS was relatively large. In usually at the last part, this study indicated that the attenuation and SOS are potential indices for evaluating the properties of tendon noninvasively. Most importantly, comparing the thickness measurement, the correlation between the thickness evaluated by ultrasonic technique and the cross-sectional area was statistically significant, with high correlation coefficient (R2=0.74). Therefore, it would be greatly helpful for calculating QUS parameters, and for analyzing non-uniform soft tissues.

中文摘要………………………………………………………………I
英文摘要………………………………………………………………II
誌謝……………………………………………………………………III
目錄……………………………………………………………………IV
圖目錄索引……………………………………………………………VI
表目錄索引……………………………………………………………X
第一章 緒論……………………………………………………………1
第1-1節 肌腱組織之構造…………………………………………….1
第1-2節 阿基里斯腱簡述…………………………………………….2
第1-3節 臨床肌腱診斷方法與簡介………………………………….3
第1-4節 文獻回顧…………………………………………………….4
第1-5節 研究動機與目的……………………………………………10
第1-6節 論文架構……………………………………………………11
第二章 研究原理與材料…………………………………………….12
第2-1節 超音波簡介…………………………………………………12
第2-1-1節 音波特性…………………………………………………12
第2-1-2節 超音波掃描方式…………………………………………12
第2-2節 定量式超音波參數…………………………………………13
第2-3節 超音波縱向解析度…………………………………………18
第2-4節 雷射測距機之截面積計算…………………………………19
第2-4-1節 截面積訊號量測…………………………………………19
第2-4-2節 截面積訊號重建…………………………………………19
第2-5節 實驗材料-離體豬肌腱…………………………………….24
第三章 系統架構與實驗流程……………………………………….26
第3-1節 實驗架構……………………………………………………27
第3-2節 硬體詳述……………………………………………………29
第3-2-1節 超音波探頭………………………………………………29
第3-2-2節 超音波Pulser/Reciver & A/D card………………….31
第3-2-3節 電子式拉力計與治具……………………………………33
第3-2-4節 Micro Laser Sensor雷射測距機………………………37
第3-2-5節 旋轉機構…………………………………………………39
第3-2-6節 雷射測距機訊號擷取……………………………………39
第3-3節 離體豬腱處理………………………………………………41
第3-4節 實驗設計……………………………………………………42
第3-5節 軟體資料分析流程…………………………………………44
第四章 實驗結果與討論…………………………………………….45
第4-1節 肌腱組織面積與厚度量測…………………………………45
第4-1-1節 雷射測距機量測截面積…………………………………45
第4-1-2節 超音波量測肌腱厚度……………………………………51
第4-1-3節 厚度與截面積相關性比較………………………………52
第4-2節 定量式超音波量測肌腱組織………………………………56
第4-2-1節 中心頻率之超音波衰減…………………………………56
第4-2-2節 寬頻超音波衰減…………………………………………61
第4-2-3節 超音波波速………………………………………………64
第4-3節 結果討論……………………………………………………67
第五章 結論與未來展望…………………………………………….69
第5-1節 結論…………………………………………………………69
第5-2節 未來展望……………………………………………………70
參考文獻………………………………………………………………72
附錄 實驗結果……………………………………………………….76

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