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1.上海中医药大学附属曙光医院超声医学科(上海 201203)
2.上海中医药大学附属曙光医院石氏伤科(上海 201203)
3.上海市中医药研究院中医骨伤科研究所(上海 201203)
赵璐璐,女,博士研究生,主治医师,主要从事肌骨弹性超声及介入超声的相关研究工作
王翔,副主任医师,副教授,硕士研究生导师; E-mail: w8x@163.com
纸质出版日期:2024-09-10,
收稿日期:2023-10-24,
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赵璐璐,盛建国,郭小玉,等.超声弹性成像技术评估腰部“筋”伤的可行性临床研究[J].上海中医药杂志,2024,58(9):45-49.
ZHAO Lulu,SHENG Jianguo,GUO Xiaoyu,et al.Clinical study on feasibility of assessing lumbar "tendon" injuries with ultrasound elastography[J].Shanghai Journal of Traditional Chinese Medicine,2024,58(9):45-49.
赵璐璐,盛建国,郭小玉,等.超声弹性成像技术评估腰部“筋”伤的可行性临床研究[J].上海中医药杂志,2024,58(9):45-49. DOI: 10.16305/j.1007-1334.2024.2310099.
ZHAO Lulu,SHENG Jianguo,GUO Xiaoyu,et al.Clinical study on feasibility of assessing lumbar "tendon" injuries with ultrasound elastography[J].Shanghai Journal of Traditional Chinese Medicine,2024,58(9):45-49. DOI: 10.16305/j.1007-1334.2024.2310099.
目的
2
探讨超声弹性成像技术(声辐射力脉冲成像技术)量化评估腰部“筋”伤的临床可行性。
方法
2
选取90例被诊断为单侧慢性非特异性腰痛患者(经3个月强筋功法训练后已无腰痛症状)。在训练前后,采用彩色多普勒超声诊断仪检查所有患者L
4
~L
5
节段两侧多裂肌并测量多裂肌厚度、截面积,利用声辐射力脉冲成像技术测量多裂肌剪切波速度(SWV)。
结果
2
①最终共收集90例患者,其中男性26例、女性64例,平均年龄(28.49±5.81)岁,平均体质量指数(22.20±2.45)kg·m
-2
。②训练前,疼痛侧与非疼痛侧多裂肌的厚度、截面积及SWV的差异均具有统计学意义(
P
<
0.05)。训练后,疼痛侧与非疼痛侧多裂肌的厚度、截面积及SWV的差异均无统计学意义(
P
>
0.05)。③训练后,浅层与深层多裂肌的深度及SWV比较,差异具有统计学意义(
P
<
0.05)。④训练后,两侧多裂肌厚度的平均值、截面积的平均值和SWV的平均值之间存在相关性(
r
=0.311,
P
=0.004;
r
=0.316,
P
=0.003)。⑤训练后,两侧多裂肌SWV重复测量的组内一致性良好(
P
<
0.05)。
结论
2
声辐射力脉冲成像技术是量化评估腰骶部“筋”形态功能的可靠手段,可用于指导和评价慢性筋骨病从“筋”论治,适合临床推广应用。
Objective
2
To explore the clinical feasibility of using ultrasound elastography (acoustic radiation force impulse imaging)to quantitatively assess lumbar "tendon" injuries.
Methods
2
Ninety subjects diagnosed with chronic non-specific low back pain, who were symptom-free after undergoing tendon-strengthening exercises, were recruited. Using a color Doppler ultrasound, the thickness and cross-sectional area of the bilateral multifidus muscles at the L
4
-L
5
segment were measured, and the shear wave velocity (SWV) was measured using acoustic radiation force impulse (ARFI) imaging.
Results
2
①The study ultimately included 90 participants (26 males, 64 females) with an average age of (28.49±5.81) years and an average BMI of (22.20±2.45) kg·m
-2
. ②Before training, the differences in thickness, cross-sectional area and SWV of the multifidus muscle between the painful side and the contralateral side were statistically significant (
P
<
0.05). After trai
ning, there was no statistically significant difference in the thickness, cross-sectional area, or SWV of the multifidus muscles between the painful side and the contralateral side (
P
>
0.05). ③After training, the comparison of the depth and SWV between the superficial and deep layers of the multifidus muscles showed statistically significant differences (
P
<
0.05). ④After training, there was a correlation between the average thickness, average cross-sectional area, and average SWV of the bilateral multifidus muscles (
r
=0.311,
P
=0.004;
r
=0.316,
P
=0.003). ⑤After training, the intra-group consistency of repeated SWV measurements was good for both the left and right multifidus muscles (
P
<
0.05).
Conclusion
2
ARFI imaging is a reliable method for quantitatively assessing the morphological and functional characteristics of lumbar "tendons". It is suitable for clinical application to guide and evaluate the treatment of chronic musculoskeletal conditions from a "tendon" perspective.
腰痛“筋”伤超声检查肌骨超声声辐射力脉冲成像石氏伤科中医骨伤学
lumbodynia"tendon" injuryultrasonic examinationmusculoskeletal ultrasoundacoustic radiation force impulse imagingShi's traumatology and orthopedicstraditional Chinese traumatology and orthopedics
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