高频超声联合剪切波弹性成像在脑卒中吞咽障碍评估中的应用

Application of high-frequency ultrasound combined with shear wave elastography in the assessment of dysphagia in cerebral apoplexy

目的探究高频超声联合剪切波弹性成像(SWE)在脑卒中吞咽障碍评估中的应用价值。方法选取2022年4月至2023年4月九江市中医医院收治的30例脑卒中吞咽障碍患者纳入研究组,同期于九江市中医医院就诊与研究组年龄相匹配的无吞咽障碍的30例体检老年人纳入对照1组,同期30例脑卒中无吞咽障碍患者纳入对照2组,所有参检者均接受高频超声联合SWE检查。比较三组舌肌厚度变化、舌骨位移幅度及舌骨肌的弹性模量超声测量值,分析舌肌厚度变化、舌骨位移幅度及舌骨肌的弹性模量超声测量值与脑卒中吞咽障碍患者病情严重程度的相关性。结果研究组舌肌厚度变化及舌骨位移幅度均小于对照1组及对照2组,舌骨弹性模量超声测量值高于对照1组及对照2组,差异有统计学意义(P<0.05);对照1组舌肌厚度变化及舌骨位移幅度均大于对照2组,舌骨弹性模量小于对照2组,差异有统计学意义(P<0.05)。Spearman相关性分析显示,舌肌厚度变化及舌骨位移幅度与脑卒中吞咽障碍患者病情严重程度呈负相关(r=-0.364、-0.312,P=0.006、0.013);舌骨弹性模量与脑卒中吞咽障碍患者病情严重程度呈正相关(r=0.244,P<0.001)。结论高频超声联合SWE在脑卒中吞咽障碍患者病情评估中具有较高的临床应用价值,能够准确评估患者病情严重程度,为临床诊疗提供可靠的参考,值得推广应用。

Objective To explore the value of high-frequency ultrasound combined with shear wave elastography(SWE)in the assessment of dysphagia in cerebral apoplexy.Methods Thirty cerebral apoplexy patients with dysphagia treated in Jiujiang Hospital of Traditional Chinese Medicine from April 2022 to April 2023 were enrolled in the study group,thirty elderly physical examination patients with no dysphagia,matching the age of the study group during the same period were enrolled in the control group 1,and thirty cerebral apoplexy patients with no dysphagia during the same period were enrolled in the control group 2,all participants were examined by high-frequency ultrasound combined with SWE.The ultrasonic measurements of hyoid muscle thickness change,hyoid bone displacement amplitude and hyoid muscle elastic modulus were compared among the three groups,and the correlation between hyoid muscle thickness change,hyoid bone displacement amplitude and ultrasonic measurements of hyoid muscle elastic modulus and the severity of cerebral apoplexy patients with dysphagia was analyzed.Results The changes of hyoid muscle thickness and hyoid bone displacement in study group were smaller than those in control group 1 and control group 2,and the ultrasonic measurement of hyoid elastic modulus was higher than that in control group 1 and control group 2,with statistical significances(P<0.05).The changes of hyoid muscle thickness and hyoid bone displacement in control group 1 were greater than those in control group 2,and the elastic modulus of hyoid bone was smaller than that in control group 2,with statistical significances(P<0.05).Spearman correlation analysis showed that lingual muscle thickness and hyoid displacement amplitude were negatively correlated with the severity of dysphagia in cerebral apoplexy patients(r=-0.364,-0.312,P=0.006,0.013).Hyoid elastic modulus was positively correlated with the severity of dysphagia in cerebral apoplexy patients(r=0.244,P<0.001).Conclusion High-frequency ultrasound combined with SWE has high clinical application value in the assessment of the condition of dysphagia in cerebral apoplexy patients.It can accurately assess the severity of the patient's condition,provide reliable reference for clinical diagnosis and treatment,and it is worth popularizing.