影像科学与光化学 ›› 2023, Vol. 41 ›› Issue (1): 79-83.DOI: 10.7517/issn.1674-0475.221007

• 综述与论文 • 上一篇    下一篇

肌骨超声、SMI联合SWE技术在观察NLBP患者相关肌肉特征变化中的应用

郝振民1, 郭振宁2, 邓宇光2, 吴冬倩1, 张胜楠3   

  1. 1. 衡水市人民医院超声二科, 河北 衡水 053000;
    2. 衡水市人民医院超声一科, 河北 衡水 053000;
    3. 衡水市第四人民医院超声科, 河北 衡水 053000
  • 收稿日期:2022-10-11 出版日期:2023-01-23 发布日期:2023-01-31
  • 通讯作者: 郝振民
  • 基金资助:
    2022年河北省医学科学研究课题(20220466)

Application of Musculoskeletal Ultrasound, SMI Combined with SWE in the Observation of the Changes of Relevant Muscle Characteristics in Patients with NLBP

HAO Zhenmin1, GUO Zhenning2, DENG Yuguang2, WU Dongqian1, ZHANG Shengnan3   

  1. 1. Second Department of Ultrasound, Hengshui People's Hospital, Hengshui 053000, Hebei, P. R. China;
    2. First Department of Ultrasound, Hengshui People's Hospital, Hengshui 053000, Hebei, P. R. China;
    3. Ultrasound Department of Hengshui Fourth People's Hospital, Hengshui 053000, Hebei, P. R. China
  • Received:2022-10-11 Online:2023-01-23 Published:2023-01-31

摘要: 本文探讨采用肌骨超声、超微血管成像(SMI)、实时剪切波弹性成像(SWE)技术观察非特异性下腰痛(NLBP)患者相关肌肉特征的变化及其临床意义。选取确诊NLBP的200例患者作为NLBP组、100例身体健康的志愿者(无腰部疼痛体征和表现)作为对照组,采用SMI、SWE技术、肌骨超声测定两组研究对象腹外斜肌、腹横肌、髂腰肌、竖脊肌、多裂肌的损伤情况、弹性模量及厚度值;所有NLBP患者接受康复治疗,并观察康复治疗前后各组肌群弹性模量及厚度变化。NLBP组患者的腹外斜肌、腹横肌、髂腰肌、竖脊肌、多裂肌厚度测定值、弹性模量值均低于对照组患者(P<0.05)。经SMI检查,NLBP组患者的腹外斜肌、竖脊肌、多裂肌损伤阳性率均高于对照组患者(P<0.05)。NLBP组患者治疗后的腹外斜肌、腹横肌、髂腰肌、竖脊肌、多裂肌厚度测定值及弹性模量值均较康复治疗前显著提高(P<0.05)。NLBP患者存在相关肌群萎缩、肌肉弹性强度变差的情况,采用肌骨超声、SMI、SWE可有效观察患者肌肉损伤及萎缩、弹性强度变化,并可量化康复情况。

关键词: 肌骨超声, 实时剪切波弹性成像, 非特异性下腰痛, 弹性模量, 肌肉厚度

Abstract: This paper investigated the changes of related muscle characteristics and their clinical significance in patients with non-specific low back pain (NLBP) by musculoskeletal ultrasound, superb microvascular imaging (SMI) and real-time shear wave elastography (SWE). 200 patients with NLBP were selected as the NLBP group, and 100 healthy volunteers (without signs and manifestations of lumbar pain) were selected as the control group. SMI, SWE technology and musculoskeletal ultrasound were used to determine the injury, elastic modulus and thickness of external oblique muscle, transverse abdominis muscle, iliopsoas muscle, erector spinae muscle and multifidus muscle of the two groups. All NLBP patients received rehabilitation treatment, and the changes of elastic modulus and thickness of muscle groups were observed before and after rehabilitation treatment. The thickness measurement and elastic modulus of external oblique muscle, transverse abdominis muscle, iliopsoas muscle, erector spinae muscle and multifidus muscle in NLBP group were lower than those in control group (P<0.05). After SMI examination, the positive rate of external oblique muscle, erector spinae muscle and multifidus muscle injury in NLBP group were all higher than those in control group (P<0.05). The thickness measurement, thickness and elastic modulus of external oblique muscle, transverse abdominis muscle, iliopsoas muscle, erector spinae muscle and multifidus muscle in NLBP group after treatment were significantly higher than those before rehabilitation treatment (P<0.05). NLBP patients have muscle atrophy and poor muscle elastic strength, musculoskeletal ultrasound, SMI and SWE can effectively observe the changes of muscle injury, atrophy and elastic strength in patients, and quantify the rehabilitation situation.

Key words: musculoskeletal ultrasound, real-time shear wave elastography, non-specific low back pain (NLBP), elastic modulus, muscle thickness