神经肌肉疾病骨骼肌结构与功能的定量超声研究进展

神经肌肉疾病（NMDS）危害影响大,可累及包括运动神经元和感觉神经元,肌肉本身或神经肌肉接头,临床表现为运动系统或神经系统受损相关的多种综合征或畸形,例如肌肉萎缩、肌肉营养不良等。以往NMDS的诊断主要依靠血清肌酸激酶（creatine kinase,CK）水平的测定、肌电图与神经传导速度的测量、基因检测以及肌肉活检。CK诊断肌营养不良症者灵敏度较高但特异性不足,肌电图与神经传导速度的测量、基因检测以及肌肉活检推广应用受局限。近年来,随着高频超声的发展,超声技术在疑似神经肌肉疾病诊断评估中的应用价值被广泛认可,相对于其他影像学技术来说,具有无创、无痛、无辐射的独特优势,可用于床旁,并可以动态观察骨骼肌肉系统的运动特征。越来越多的证据表明,骨骼肌超声是一种良好的生物标记,可以在肌肉疾病诊疗过程中随时间推移跟踪组织形态学、血流灌注、弹性质地变化,然而基于肌肉超声不可避免的各向异性伪像、操作者主观局限性,探索定量超声将有助于为NMDS中骨骼肌结构与功能提供客观可靠的诊断评估方法。

Quantitative ultrasound for skeletal muscle structure and function of neuromuscular diseases: research progress

Neuromuscular diseases (NMDs) are heterogeneous diseases that can act on the functions of the peripheral nervous system including neurons, muscles and neuromuscular junctions, seriously acting on the quality of life, and the outcome is irreversible. Early diagnosis and early treatment are critical to the formulation of NMDS treatment strategies and the be responsible for of later living standards. In the past, the diagnosis of NMDS mainly relied on the determination of creatine kinase levels, the measurement of electromyography and nerve conduction velocity, genetic testing, and muscle biopsy. However, these methods have low diagnostic efficiency and are invasive.In recent years, skeletal muscle ultrasound imaging has been increasingly used as an useful supplement for clinical and electrophysiological examinations of neuromuscular diseases, but the quantitative diagnosis and evaluation of skeletal muscle structure and function needs to be detailed. Based on literature review combined with practical research experience, this article summarizes the current research status of skeletal muscle quantitative ultrasound in the diagnosis and evaluation of NMDS.