腰背部肌筋膜疼痛综合征激痛点的剪切波弹性模量研究

目的 通过剪切波弹性成像(SWE)技术研究肌筋膜疼痛综合征激痛点的弹性特征,探索弹性超声技术在肌筋膜疼痛综合征临床诊断中的应用价值.方法 对8例女性健康志愿者的8个正常点和15例女性肌筋膜疼痛综合征患者腰背部30个激痛点行弹性超声检查,分别获得正常点、激痛点病灶区及邻近区定量分析取样框(Q-box)内弹性模量的均值(Mean)、最小值(Min)、最大值(Max)及标准差(SD);比较正常点、激痛点病灶区及临近区的弹性模量差异,探索激痛点弹性模量与患者年龄、所在部位的关系.结果 激痛点病灶区弹性模量的均值、最小值、最大值、标准差显著高于邻近区及正常点,其差异具有统计学意义(P＜0.05);而邻近区与正常点的弹性模量差异无统计学意义(P＞0.05),两个年龄组和3个不同部位激痛点的弹性模量差异亦无统计学意义(P＞0.05).结论 剪切波弹性模量值可用于激痛点病灶区与临近区及正常组织的鉴别,为激痛点的定位提供了新方法,也为肌筋膜疼痛综合征的触诊提供了新依据,具有较高的临床应用价值和研究前景.

Study on the elastic modulus of shear wave for myofascial trigger points of lumber and back myofascial pain syndrome

Objective To investigate the clinical diagnostic value of elastography in myofascial pain syndrome by measuring the elastic properties of myofascial trigger points.Methods The elastic modulus of 30 myofascial trigger points from 15 female patients with myofascial pain syndrome and 8 normal points from 8 female healthy volunteers were measured by shear wave elastography.The mean,min,max,and standard deviation (SD) of elastic modulus in lesions,surrounding tissue of myofascial trigger point and normal points were recorded and compared,and the correlation between elasticity of myofascial trigger points and age,location were analyzed.Results The mean,min,max,and standard deviation of elastic modulus in lesion area of myofascial trigger point were significantly higher than that in surrounding tissue and normal points (P＜0.05).There were no significant differences between lesion area of myofascial trigger point and normal points (P＞0.05),and elastic modulus of myofascial trigger points bore no relation to age and location (P＞0.05).Conclusions Shear wave elastic modulus can be used to differentiate lesion area and its adjacent area of trigger points and normal points,which will provide a new way to identify myofascial trigger point and new basis for palpation,thus has higher application value in clinical and research prospect.