剪切波弹性成像技术评估卒中伴发上肢肌痉挛患者屈肌肌群硬度变化的应用价值

Application value of shear wave ultrasound elastographic technology for evaluating hardness change of upper limb spastic muscle group in patients with stroke

目的探讨剪切波弹性成像(SWE)技术评估卒中伴发上肢肌痉挛患者屈肌肌群硬度变化的应用价值。方法选取42例卒中伴发单侧上肢肌痉挛患者为研究对象,对患侧和健侧上肢肱二头肌(BBM)、肱桡肌(BRM)、桡侧腕屈肌(FCR)、尺侧腕屈肌(FCU)行SWE检查并记录杨氏模量值,分析杨氏模量值与改良Ashworth量表(MAS)评分和简化Fugl-Meyer运动功能评定表(FMA)评分之间的相关性,比较健侧和患侧杨氏模量值的差异。结果拉伸位患侧BBM、BRM、FCR、FCU的杨氏模量值与FMA评分无相关性(P>0.05),与MAS评分呈正相关(P<0.05)。放松位患侧BBM、BRM、FCR、FCU的杨氏模量值明显高于健侧(P<0.05)。拉伸位患侧和健侧BBM、BRM、FCR、FCU的杨氏模量值均较放松位明显增高(P<0.05);患侧BBM、BRM、FCR、FCU被动拉伸前后杨氏模量值差值比健侧大(P<0.05)。结论SWE可以评估卒中伴发上肢肌痉挛患者屈肌肌群硬度的变化。

Objective To investigate the application value of shear wave ultrasound elastography(SWE)technology for evaluating the hardness of upper limb spastic muscle group in the patients with stroke.Methods Forty-two patients with stroke complicating unilateral upper limb muscle spasm were selected as the study subjects.The biceps brachii muscle(BBM),brachioradialis(BRM),flexor carpi radialis muscle(FCR)and flexor carpi ulnaris muscle(FCU)in the affected side and healthy side conducted the SWE examination and the Young modulus values were recorded.The correlation between the Young modulus values with the modified Ashworth scale(MAS)score and the simplified Fugl-Meyer Motor Function Rating Scale(FMA)score was analyzed.The difference in the Young modulus values were compared between the healthy side and affected side.Results In the tensional positions,the Young’s modulus value of BBM,BRM,FCR and FCU in the affected side had no correlation with the FMA score(P<0.05),but had the positive correlation with the FMA score(P>0.05).In the relaxed position,the Young’s modulus value of BBM,BRM,FCR and FCU in the affected side were significantly higher than those in the healthy side(P<0.05).The Young’s modulus values of BBM,BRM,FCR and FCU in the stretching position in the affected side and healthy side were significantly increased compared with those in the relaxed position.The difference value of the Young modulus values of BBM,BRM,FCR and FCU in the affected side between before and after the passive stretching was greater than that in the healthy side(P<0.05).Conclusion SWE could evaluate the hardness change of upper limb flexor muscle group in the patients with stroke.