Application Value of Multimodal Ultrasound in the Diagnosis of Piriformis Syndrome
Objective To explore the application value of multimodal ultrasound in the diagnosis of piriformis syndrome(PMS).Methods Seventy patients with PMS on one side diagnosed and treated in the Shiyan Renmin Hospital from Janu-ary 2021 to May 2023 were selected to undergo two-dimensional ultrasound,shear wave elastography(SWE),and ultra micro angiography(UMA)detection.The detection consistency between the same and different observers was evaluated u-sing intra-class correlation coefficient(ICC).The piriformis(PM)thickness,mean Young's modulus(Emean),and con-trast per pixel(CPP)between the healthy and affected sides were compared.ROC curves were drawn and the area under the curve(AUC)was calculated.Results There was good consistency in the detection of PM thickness,Emean,and CPP among the same observer(ICC 0.91,0.85,and 0.86,respectively)and different observers(ICC 0.87,0.87,and 0.84,respectively).The patients had thicker PM,higher Emean,and higher CPP on the affected side than on the healthy side(P<0.05).The ROC curves showed that the AUC for diagnosing PMS through PM thickness was 0.743,with a cutoff value of 22.5 mm,sensitivity of 80.0%,and specificity of 61.4%;the AUC through Emean was 0.837,with a cutoff value of 32.5 kPa,sensitivity of 77.1%,and specificity of 81.4%;that through UMA was 0.695,with a cutoff value of 0.555%,sensitivity of 61.4%,and specificity of 80.0%.The AUC of the combined diagnosis of PMS with the three indicators was 0.894,with a sensitivity and specificity of 84.3%.Conclusion On the basis of two-dimensional ultrasound examination,combined SWE and UMA can improve the diagnostic efficiency of PMS.