基于剪切波超声弹性成像评价不同姿势对胸腰筋膜和斜方肌组织硬度的影响

Evaluation on the effects of different postures on the stiffness of thoracolumbar fascia and trapezius muscle by shear wave elastography

目的:利用剪切波弹性成像技术研究健康男性受试者在不同姿态下胸腰筋膜和斜方肌硬度变化,以了解姿态对胸腰筋膜硬度的影响和探索胸腰筋膜与斜方肌之间的关系。方法:招募20名健康男性青年分别在无前倾坐位、前倾30°坐位和前倾60°坐位下,利用剪切波弹性超声(SWE)测量右侧胸腰筋膜(L1-2、L3-4)和斜方肌(T5-6、T7-8、T9-10、T11-12)的硬度。结果:与无前倾坐位相比,随着前倾坐位的角度增加,胸腰筋膜(L3-4、L1-2)和斜方肌(T11-12)的硬度显著增加(P<0.05);斜方肌(T5-6)的肌肉硬度在前倾30°时无显著增长(P>0.05),在前倾60°时肌肉硬度极显著增加(P<0.001);所有测量点的硬度变化均与胸腰筋膜L3-4处的硬度变化有极强相关性(r>0.8)。结论:胸腰筋膜与斜方肌之间存在极显著的连续性,且前倾坐位能够显著增加胸腰筋膜的硬度,进而影响到斜方肌的硬度。

Objective:To study the changes of thoracolumbar fascia(TLF)and trapezius shear modulus using shear wave elastography(SWE)in healthy male subjects under different body postures and to understand the effect of posture on TLF and the relationship between TLF and trapezius muscle.Method:Sitting position,Sitting-forward 30°and Sitting-forward 60°,were defined to evaluate the shear modulus of right side at the TLF(L1-2,L3-4)and trapezius muscle(T5-6,T7-8,T9-10,T11-12)in twenty healthy male subjects.Measurements were taken three times for each posture.Result:Compared with sitting position,the extremely significant increase in stiffness of the TLF(L3-4,L1-2)and trapezius muscle(T11-12)was observed accompanied with increased anteversion angle(P<0.001).The stiffness of trapezius muscle(T7-8,T9-10)increased significantly at sitting-forward30°(P<0.05),and extremely significantly increased at sitting-forward60°(P<0.001);The stiffness of trapezius muscle(T5-6)did not increase significantly at sitting-forward30°(P>0.05),but extremely significantly increased at sitting-forward60°(P<0.001);There was a strong correlation between the changes of hardness of all measurement points and the changes of L3-4 of TLF(r>0.8).Conclusion:There was a very significant continuity in hardness between TLF and trapezius muscle,and the sitting forward position could significantly increase the stiffness of the TLF,and then affect the stiffness of the trapezius muscle.