摘要
目的:初步探讨应用超声剪切波弹性超声成像技术定量评估脑卒中患者痉挛的肱三头肌长头和外侧头在不同伸肘角度以及肌肉不同深度硬度变化的临床价值。方法:选取2021年12月1日—2022年11月30日就诊于上海市第五人民医院康复科门诊和病房及神经内科病房的脑卒中偏瘫患者共60例,其中男性44例,女性16例,平均年龄(65.15±9.29)岁。采用佳能Aplio500超声弹性诊断仪,14L5型线阵探头,采用单点剪切波测量技术定量比较肱三头肌长头和外侧头痉挛侧与非痉挛侧、伸肘180°和伸肘90°以及浅层与深层剪切波速度(SWV)的差异,采用改良Ashworth量表(MAS)评定患侧肱三头肌肌张力,Fugl-Meyer运动功能评定(FAM)评估患侧上肢运动功能。结果:患侧肱三头肌长头和外侧头肌肉在不同伸肘角度(伸肘180°和伸肘90°)和不同深度(浅层和深层)的SWV值均显著高于健侧(Z≥5.544,P<0.001);伸肘180°位和伸肘90°位,双侧肌肉的深层SWV值均明显高于浅层(Z≥5.018,P<0.001)。患侧和健侧肱三头肌长头和外侧头浅层和深层的SWV值在伸肘90°时均显著高于伸肘180°位(Z≥6.650,P<0.001)。伸肘90°位和伸肘180°位SWV差值比较,患侧肱三头肌长头明显高于健侧(Z≥5.982,P<0.001),患侧肱三头肌外侧头高于健侧(Z≥2.654,P<0.01)。伸肘90°时,患侧肱三头肌长头和外侧头浅层和深层的SWV值均与MAS评分呈显著正相关(r≥0.751,P<0.001),与上肢FAM评分呈负相关(r≤-0.377,P<0.05)。患侧肱三头肌MAS分级和患侧上肢FAM评分呈负相关(r=-0.562,P<0.001)。结论:超声剪切波弹性成像技术可用于评估脑卒中后痉挛肱三头肌的硬度的变化。
Purpose:To investigate the clinical value of shear wave elastography in quantitatively evaluating the changes in the long and lateral heads of the triceps brachi muscle(TBM)at different elbow extension angles and muscle depths in stroke patients.Methods:A total of 60 post-stroke hemiplegic patients were selected in the outpatient clinic and wards of the Department of Rehabilitation and Neurology of Shanghai Fifth People's Hospital from December 1,2021 to November 30,2022.The patients included 44 male cases and 16 female cases,with an average age of(65.15±9.29)years.The Canon Aplio500 ultrasonic elastic diagnostic instrument,14L5 array probe,single-point shear-wave measurement technique was used to quantitatively compare the difference of shear wave velocity(SWV)between the long and lateral heads of TBM at elbow extension at 180°and 90°,superficial and deep layer of the muscle on spastic side and non-spastic side.The modified Ashworth scale(MAS)was used to assess the triceps muscle tone on the affected side and the Fugl-Meyer motor function assessment(FAM)to assess the upper limb motor function on the affected side.Results:The SWV values of the long and lateral heads of TBM on the affected side were significantly higher at different angles(180°and 90°)and layers(superficial and deep)(Z≥5.544,P<0.001);At elbow extension at 180°and 90°,the SWV values of deep layer of TBM were significantly higher than that of the superficial layer(Z>5.018,P<0.001).The SWV values of the long and lateral heads of the TBM at 900 elbow extension were significantly higher than that at the 180°elbow extension(Z≥6.650,P<0.001).Comparing the difference between SWV of elbow extension at 90°and at 180°,the long TBM head on the affected side was significantly higher than that at the unaffected side(Z≥5.982,P<0.001),and also the lateral TBM head on the affected side was higher than that on the unaffected side(Z>2.654,P<0.01).The SWV value in the superficial and deep layers of the lateral triceps at 90°elbow extension was signif
作者
张丰兰
陈庆珍
曹伟田
李莹莹
周亚飞
胡世红
ZHANG Fenglan;CHEN Qingzhen;CAO Weitian;LI Yingying;ZHOU Yafei;HU Shihong(Department of Rehabilitation Medicine,Shanghai Fifth People's Hospital,Shanghai 200240,China;Department of Ultrasound Medicine,Shanghai Fifth People's Hospital)
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2023年第5期577-583,共7页
Chinese Computed Medical Imaging
基金
闵行区自然科学基金(2021MHZ063)。
关键词
剪切波弹性成像
脑卒中
痉挛
肱三头肌
剪切波速度
Shear wave elastography
Stroke
Spastic
Triceps brachi muscle
Shear wave velocity
