剪切波超声弹性成像技术在颈肩肌筋膜疼痛综合征中的应用

目的 :探讨剪切波超声弹性成像技术在颈肩肌筋膜疼痛综合征中的应用。方法 :选取2013年12月至2014年7月临床诊断为颈肩肌筋膜疼痛综合征的患者30例(病例组)及对照组30例(健康人群)。病例组男17例,女13例,平均年龄(44±3)岁;对照组男22例,女8例,平均年龄(37±5)岁。病例组患者行手法治疗,隔日1次,共7次,分别以剪切波超声弹性成像技术检测病例组患者治疗前后斜方肌紧张处,以及对照组斜方肌降部肌腹,记录并比较组织弹性图和杨氏模量值,对结果进行统计分析。结果:病例组治疗前斜方肌组织弹性图以绿蓝色为主,弹性评分3.70±1.53,杨氏模量值(43.4±15.6)k Pa;治疗后组织弹性图以蓝色为主,弹性评分2.40±0.87,杨氏模量值(29.0±5.9)k Pa;对照组组织弹性图以蓝色为主,弹性评分1.60±0.72,杨氏模量值(24.0±7.6)k Pa;三者两两比较,P=0.000,差异均有统计学意义。结论:剪切波超声弹性成像技术可作为检测中医手法治疗颈肩肌筋膜疼痛综合征疗效的客观检测方法,且较敏感。

Application of shear wave elastography in the evaluation of neck-shoulder myofascial pain syndrome

Objective:To study clinical value of shear wave elastography(SWE) in the evaluation of neck-shoulder myofascial pain syndrome. Methods:From December 2013 to July 2014,30 patients diagnosed as neck-shoulder myofascial pain syndrome were in the treatment group,including 17 males and 13 females,with an average age of (44±3) years old. Thirty healthy people were in the control group,including 22 males and 8 females,with a mean age of (37±5) years old. The patients in the treatment group were treated with manipulation,once every other day,total 7 times. The SWE was used to detect tension part of trapezius muscle of patients in the treatment group before and after treatment,as well as to detect muscle belly at the descending part of trapezius muscle in the control group. The tissue elasticity and Yang's modulus value were recorded and compared. Results:The tissue elasticity chart of patients in the treatment group before treatment was mainly greenish blue with the score of 3.70±1.53,and the Yang's modulus was(43.4±15.6) kPa. The tissue elasticity figure after treatment was mainly blue with the score of 2.40±0.87,and the Yang's modulus was(29.0±5.9) kPa. Whereas in the control group,the tissue elasticity figure was mainly blue with the score of 1.60±0.72,and the Yang's modulus was (24.0±7.6) kPa. These were statistical differences between the two groups(P=0.000). Conclusion:SWE can be used as an evaluation method of manipulation treatment for neck-shoulder myofascial pain syndrome,which is an objective and sensitive detection method.