实时剪切波弹性成像技术评估脑卒中后下肢肌张力的研究

Study of real-time shear wave elastography in evaluating the lower limb muscle tension after stroke

摘要:

目的探讨实时剪切波弹性成像技术应用于脑卒中后肌痉挛患者肌张力评估的可行性。方法选取脑卒中后下肢肌痉挛患者30 例作为病变组，同时选取健康志愿者30 例作为对照组。测量所有病变组双侧、对照组右侧腓肠肌的杨氏模量值，进行对比分析。结果俯卧位时病变组患侧、健侧及对照组腓肠肌杨氏模量值分别为（62.28±19.22）、（22.47±7.42）及（20.47±2.47）kPa，仰卧位时病变组患侧、健侧及对照组腓肠肌杨氏模量值分别为（62.44±18.49）、（21.10±2.28）及（20.17±2.13）kPa，病变组患侧腓肠肌杨氏模量值高于健侧及对照组（P <0.05）。结论实时剪切波成像技术能够定量评估脑卒中后下肢痉挛肌的硬度变化，客观地评定肌张力的变化，从而指导临床治疗。

Abstract:

Objective To explore the feasibility of real-time shear wave elastography (SWE) in evaluating the muscle tension of patients with lower limb spasticity after stroke. Methods A total of 30 patients with lower limb spastic hemiplegia after stroke (case group) and 30 healthy volunteers (control group) were selected. The Young's moduli of the patients' gastrocnemius muscle in both sides and volunteers' right gastrocnemius muscle were measured by SWE. Results In prone position, the average Young's moduli of the gastrocnemius muscle in the pathological side of the case group, contralateral side of the case group, and right gastrocnemius of the control group were (62.28 ±19.22) kPa, (22.47 ±7.42) kPa and (20.47 ±2.47) kPa,respectively. In supine position, the average Young's moduli of the gastrocnemius muscle in the pathological side of the case group, contralateral side of the case group, and right gastrocnemius of the control group were(62.44 ±18.49) kPa, (21.10 ±2.28) kPa and (20.17 ±2.13) kPa, respectively. The mean young's moduli of the gastrocnemius muscle in the pathological side of the case group were higher than those in the contralateral side of the case group and right gastrocnemius of the control group (P < 0.05). Conclusions SWE can quantitatively assess the stiffness variation of the spasticity muscle and evaluate the change of muscle tension,which can direct clinical treatment.