剪切波弹性成像技术评估青少年特发性脊柱侧凸椎旁肌生物学特征的分析
Analysis of the biological characteristics of paraspinal muscles in adolescent idiopathic scoliosis evaluated by shear wave elastography technology
郑海平 1范云丽 2冯林 3许晓华 4许季春 3董振宇 4刘力 4姜伟5
作者信息
- 1. 广东医科大学 广东 湛江 524023;香港大学深圳医院超声科 广东 深圳 518053
- 2. 香港大学深圳医院康复科 广东 深圳 518053
- 3. 香港大学深圳医院小儿骨科 广东 深圳 518053
- 4. 香港大学深圳医院超声科 广东 深圳 518053
- 5. 广东医科大学附属南山医院(华中科技大学协和深圳医院)超声科 广东深圳 518053
- 折叠
摘要
目的 探讨剪切波弹性成像(shear wave elastography,SWE)评估青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者脊柱两侧椎旁肌生物学特征的应用价值.方法 选取AIS患者 48 例作为侧弯组,根据半年内Cobb角增加是否大于 5°再分为进展组(24 例)和非进展组(24 例),另选取同期 24 例无脊柱侧弯的志愿者作为非侧弯组(对照组).俯卧状态下应用二维超声和SWE测量双侧多裂肌、最长肌和髂肋肌厚度和剪切波速度(shear wave velocity,SWV),计算双侧肌肉厚度(muscle thickness,MST)和剪切波速度比值(shear wave velocity ratio,SWVR)进行统计分析.结果 AIS患者的多裂肌、最长肌的SWE单侧或双侧较对照组高,差异有统计学意义(P<0.05);进展组的顶椎(apical vertebrae,AV)水平凹侧多裂肌、最长肌及髂肋肌的SWE较凸侧高,差异有统计学意义(P<0.05);非进展组AV水平、上端椎(upper end vertebrae,UEV)水平及下端椎(lower end vertebrae,LEV)水平凹凸侧椎旁肌SWE差异无统计学意义(P>0.05);进展组、非进展组及对照组之间双侧椎旁肌的厚度差异无统计学意义(P>0.05).结论 AIS患者的多裂肌、最长肌的肌肉硬度较对照组大,AIS进展期的患者AV水平凹侧的多裂肌、最长肌及髂肋肌的肌肉硬度较凸侧大,SWE可实时检测椎旁肌硬度,在评估AIS患者物理治疗效果具有一定的应用前景.
Abstract
Objective To explore the application value of shear wave elastography in evaluating the biological characteristics of the paraspinal muscles of the spine in adolescent idiopathic scoliosis(AIS)patients.Methods 48 AIS patients were se-lected as the scoliosis group,and further divided into a progressive group of 24 cases and a non-progressive group of 24 cases based on whether the Cobb angle increase was greater than 5 ° within six months.Another 24 volunteers without scoliosis during the same period were selected as the non-scoliosis control group.Two-dimensional ultrasound and shear wave elastography(SWE)were applied in a prone position to measure the thickness and shear wave velocity of bilateral multifidus,longissimus,and iliopsoas muscles.The ratio of bilateral muscle thickness to shear wave velocity was calculated and statistically analyzed.Results The shear wave velocity of the multifidus and longissimus muscles in AIS patients was significantly higher on one or both sides compared to the normal control group(P<0.05).The shear wave velocity of the multifidus muscle,longest muscle,and iliopsoas muscle on the concave side of the top vertebrae in AIS patients was higher than that on the convex side,and the dif-ference was statistically significant(P<0.05).There was no statistically significant difference(P>0.05)in the shear wave veloc-ity of the paraspinal muscles on the concave convex side of the AIS non-progressive group at the level of the top vertebra,upper vertebra,and lower vertebra.There was no statistically significant difference in the thickness of bilateral paraspinal muscles be-tween the progressive group,non-progressive group,and control group(P>0.05).Conclusion The muscle hardness of the multifidus,longissimus,and iliopsoas muscles in AIS patients is greater than that in the control group.In patients with advanced AIS,the muscle hardness of the multifidus,longissimus,and iliopsoas muscles on the concave side of the parietal vertebrae is greater than that on the convex side.Ultrasound elastography(SWE)technology can detect the hardness of paraspinal muscles in real time and has certain application prospects in evaluating the effectiveness of physical therapy in AIS patients.
关键词
青少年/脊柱侧凸/椎旁肌/剪切波弹性成像/超声检查Key words
Adolescents/Scoliosis/Paravertebral muscles/Shear wave elastography/UItrasound引用本文复制引用
出版年
2024
NETL
NSTL
万方数据