摘要
目的:探究超微血管成像(SMI)联合剪切波弹性成像(SWE)在评估非特异性腰痛(NLBP)中的临床价值.方法:回顾性选取我院2021年5月—2023年5月已确诊的223例NLBP患者作为研究对象,另选取正常健康志愿者182例作为健康组.所有受试者均采用SMI联合SWE评估腹部肌群,并评估NLBP患者治疗前后腹部肌群的变化.记录所有受试者的临床资料,比较两组腹直肌和腹横肌的厚度、SWE的平均值(Ave)、SWE的标准差(SD)以及腹直肌血流收缩期峰值流速(Vmax)、腹直肌血流舒张末期血流速度(Ved)、腹直肌血流阻力指数(RI)、NLBP患者治疗前后VAS评分.结果:NLBP组腹直肌厚度、Ave、SD、血流Vmax以及腹横肌Ave、SD均小于健康组,而腹直肌血流RI高于健康组(P<0.05).腹直肌、腹横肌相关参数联合诊断NLBP的整体效能最高,其诊断NLBP的灵敏度和特异度分别为85.2％、85.7％.NLBP患者治疗前腹直肌Ave、SD、血流Vmax、血流Ved以及腹横肌SD均小于治疗后,而治疗前血流RI高于治疗后;治疗前VAS评分高于治疗后(P<0.05).经Spearman相关性分析发现,NLBP患者腹直肌Ave、SD与腹直肌血流Vmax、血流RI呈正相关性(P<0.05),与腹直肌血流Ved无相关性(P>0.05).结论:NLBP患者腹直肌和腹横肌的Ave、SD以及肌肉血流分布小于对照组,腹直肌和腹横肌的SWE参数和SMI参数对NLBP有较高的诊断价值,两者联合能提高其诊断效能.腹直肌Ave、SD与腹直肌血流Vmax、血流RI呈正相关性.
Abstract
Objective:To assess the value of superb microvascular imaging (SMI) combined with shear wave elastography (SWE) in non-specific low back pain (NLBP). Methods:A total of 223 NLBP patients in our hospital from May 2021 to May 2023 were selected as NLBP group,and 182 healthy volunteers were enrolled as healthy group. All subjects were assessed using SMI combined with SWE. Changes in abdominal muscle before and after treatment in patients with NLBP were assessed. The clinical data of all subjects were recorded. Parameters including the thickness,average(Ave) and standard deviation(SD) of rectus abdominis and transversus abdominis,and the maximum systolic flow velocity (Vmax),end diastolic velocity (Vmin),and resistance index (RI) of rectus abdominis,as well as pre-and post-treatment visual analogue scale (VAS) scores of NLBP pa-tients were recorded in all patients. Results:The thickness,Ave,SD and Vmax of rectus abdominis,and Ave and SD of the transverse abdominis of the NLBP group were all lower than those of the healthy group,and RI of rectus abdominis was high-er than that of the healthy group(P<0.05). The combined test of parameters related to rectus abdominis and transverse abdomi-nis had the highest overall efficiency in diagnosing NLBP,with sensitivity and specificity of 85.2％ and 85.7％. Before treat-ment,Ave,SD,Vmax,and Ved of rectus abdominis and SD of transversus abdominis were lower than those after treatment,while RI of patients before treatment was higher than that after treatment (P<0.05). VAS score of patients before treatment was higher than that after treatment(P<0.05). Spearman correlation analysis denoted that Ave and SD of rectus abdominis muscle in NLBP patients were positively correlated with Vmax and RI of rectus abdominis (P<0.05),but had no correlation with Ved of rectus abdominis (P>0.05). Conclusion:The Ave,SD,and muscle blood flow distribution of rectus abdominis and transverse abdominis are decreased in NLBP patients compared to healthy controls. The SWE and SMI parameters of rectus abdominis and transverse abdominis have high diagnostic value for NLBP,and the combination of the two can improve its diagnostic effi-ciency,furthermore,Ave and SD of rectus abdominis are positively correlated with the Vmax and RI of rectus abdominis.
维普
万方数据