多模态超声在单侧周围性面瘫诊断及针灸治疗效果评估中的应用价值
Application value of multimodal ultrasound in the diagnosis of unilateral peripheral facial paralysis and the evaluation for the acupuncture treatment effect
陈娜 1张莉 2胡小丽2
作者信息
- 1. 贵州医科大学附属医院超声中心,贵州贵阳 550004;贵阳市第一人民医院超声医学科,贵州贵阳 550002
- 2. 贵州医科大学附属医院超声中心,贵州贵阳 550004
- 折叠
摘要
目的 探讨多模态超声[肌骨超声(MSKUS)、能量多普勒超声(PDUS)及声触诊弹性成像(STE)]在单侧周围性面瘫(PFP)诊断及针灸治疗疗效评估中的应用价值.方法 选取单侧PFP患者和健康者各60例分别为PFP组和对照组,收集2组受检者入组时的一般临床资料[年龄、性别及体质量指数(BMI)];PFP组受检者面部行针炙治疗(疗程4周,5 d/周,1次/d,30穴/次,留针30 min/次),采用MSKUS、PDUS及STE分别检测对照组受检者体检时和PFP组受检者治疗前和治疗后第1、2、3、4周两侧面神经颅外段内径及回声、面神经周围血流信号及面部表情肌(额肌、颧大肌、降口角肌及降下唇肌)杨氏模量值,采用ROC曲线分析PFP组患者两侧面神经内径和面部表情肌杨氏模量值对PFP临床诊断及针炙治疗效果的预测价值.结果 PFP组患者治疗前患侧面神经内径大于健侧及对照组(P＜0.05),患侧面部表情肌杨氏模量值低于健侧及对照组(P＜0.05);PFP患者治疗前两侧面神经周围血流信号分级与对照组比较,差异有统计学意义(P＜0.05);ROC分析显示,面神经内径及面部表情肌杨氏模量值诊断PFP曲线下面积均＞0.90,诊断性能较好;随着针灸治疗的进行,PFP组患侧面神经内径呈下降趋势,面部表情肌杨氏模量呈上升趋势(P＜0.01).结论 多模态超声不仅能为PFP的诊断提供客观、可量化、可重复性好的影像学依据,还能动态评估PFP针灸治疗的疗效.
Abstract
Objective To investigate the value of multimodal ultrasound musculoskeletal ultrasound(MSKUS),power doppler ultrasound(PDUS),and sound touch elastography(STE)]in the diagnosis of unilateral peripheral facial paralysis(PFP)and the assessment of acupuncture treatment effect.Methods Sixty patients with unilateral PFP and Sixty healthy subjects were selected as PFP group and control group respectively.and the general clinical data(age,sex,body mass index(BMI))were collected.The patients in PFP group were treated with acupuncture and moxibustion on the face(treatment course of 4 weeks,5 days/week,once/d,30 points/time,needle retention 30 min/time).MSKUS,PDUS and STE were used to detect the internal diameter and echoes of the extracranial segment of the facial nerve,peripheral blood flow signals around facial nerve and Young's modulus of the facial expression muscles(frontalis,zygomaticus major,depressor anguli oris and depressor labii inferioris)of both the left and right sides of the control group at physical examination and the subjects in the PFP group at the first,second,third,and fourth weeks before and after treatment respectively;and the predictive value of internal diameter of facial nerve and Young's modulus of facial expression muscle in PFP group on clinical diagnosis and acupuncture treatment effect of PFP group were analyzed by using ROC curves.Results Before treatment in the PFP group,the internal diameter of the affected facial nerve was larger than that of the healthy side and the control group(P＜0.05),and the value of Young's modulus of the facial expression muscles on the affected side was lower than that of the healthy side and the control group(P＜0.05);compared with control group,there was statistical significance in the grading of blood flow signal around facial nerve in PFP patients before treatment(P＜0.05).The ROC analysis showed that the diagnostic values of the internal diameter of the facial nerve and the value of Young's modulus of the facial expression muscles area under the curve of PFP were＞0.90 with better diagnostic performance.The internal diameter of the facial nerve on the affected side of the PFP group showed a decreasing trend,and the Young's modulus of the facial expression muscles showed an increasing trend(P＜0.01)with acupuncture treatment.Conclusions Multimodal ultrasound can not only provides an objective,quantifiable,and reproducible imaging basis for the diagnosis of PFP,but dynamically evaluate the efficacy of acupuncture treatment for PFP.
关键词
面瘫,周围性/多模态超声/肌骨超声/声触诊弹性成像/能量多普勒/针灸治疗Key words
facial paralysis,peripheral/multimodal ultrasound/musculoskeletal ultrasound/sound touch elastography/power doppler ultrasound/acupuncture treatment引用本文复制引用
基金项目
贵州省卫生健康委科学技术基金项目(gzwkj2023-068)
出版年
2024
NETL
NSTL
万方数据