声辐射力脉冲弹性成像技术在诊断肩部肌筋膜疼痛综合征中的应用价值

Application value of acoustic radiation force impulse elastography in diagnosis of myofascial pain syndrome of shoulder

目的探讨声辐射力脉冲(ARFI)弹性成像技术在诊断肩部肌筋膜疼痛综合征(MPS)的应用价值。方法选择40例肩部MPS患者作为MPS组,50例健康者作为对照组,采用ARFI弹性成像技术和常规二维超声对MPS组的肩部肌紧张处(痛点部位)和对照组的斜方肌降部肌腹处进行检测,记录常规二维超声图像,应用ARFI声触诊组织成像(VTI)技术处理获得的弹性图像,声触诊组织量化(VTQ)技术处理获得剪切波速度(SWV)。采用受试者工作特征(ROC)曲线评价SWV值对MPS的诊断效能。结果 MPS组的VTI图像较对照组暗;MPS组的SWV值为(2.57±0.62)m/s,高于对照组的(1.55±0.62)m/s(P<0.05)。ROC曲线结果显示,以2.12 m/s为SWV值的诊断界值,其敏感度为82.5%,特异度为88.0%,曲线下面积为0.882。结论 ARFI技术可作为诊断肩部MPS的潜在方法,ARFI的VTQ技术获得的SWV值可用于辅助诊断肩部MPS。

Objective To investigate the application value of acoustic radiation force impulse（ARFI） elastography in diagnosing myofascial pain syndrome（MPS） of shoulder. Methods Forty patients with MPS of shoulder and 50 healthy individuals were enrolled as MPS group and control group respectively. The tensive part （ pain points ） of shoulder muscle in the MPS group and the renter musculi of descending part of musculi trapezius in the control group were detected using ARFI elastography and regular two-dimensional（2D） ultrasound. The image of regular 2D ultrasound was recorded. Elasticity image and sheer wave velocity（SWV） were acquired by virtual touch tissue imaging （VTI） and virtual touch tissue quantification（VTQ） of ARFI respectively. Receiver operating characteristic （ROC） curve was used to evaluate the diagnostic efficiency of SWV for MPS. Results The image of VTI was darker in the MPS group compared to the control group. SWV value of the MPS group was higher than that of the control group（2.57 ± 0. 62 m/s vs. 1.55± 0. 62 m/s ;P 〈 0. 05）. The result of ROC curve showed that the sensitivity,specificity,and the area under curve were 82. 5% ,88.0% and 0. 882,respectively,when the diagnostic threshold of SWV was 2.12 m/s. Conclusion ARFI can be taken as the potential approach to diagnosing MPS of shoulder. The SWV value obtained by VTQ technology of ARFI can be applied to the auxiliary diagnosis of MPS of shoulder.