二维超声与剪切波弹性成像评估慢性腰痛患者骨骼肌变化的临床研究

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Clinical value of two-dimensional ultrasound and shear wave elastography in evaluating skeletal muscle changes in patients with chronic low back pain

ZENG Jia，GAO Yang，YANG Han Departmentof Ultrasound Medicine，ShuangliuDistrictFirstPeople'sHospitalofChengdu，WestChina（Airport）Hospital Sichuan University，Chengdu 610299，China

ABSTRACTObjective To evaluate the skeletal muscle changes in patients with chronic low back pain by twodimensionalultrasoundandshear waveelastography（SWE），andtoexploretheclinicalvalue.MethodsTotally65patients with chronic back painadmited toour hospital（observation group）and 65 healthysubjects who underwent physical examinations duringthesameperiod（healthygroup）wereselected.Thethicknessandcross-sectionalareaofbilateralmultifidus，rector spinaemusclesand the thicknessof transverseabdominis muscle were measuredbytwo-dimensionalultrasound.The average shear wave velocity（SWV）of each muscle were measured bySWE，thediferences inabove parameters between the two groups werecompared.Theconsistencyofinter-observermeasurementsoftwo-dimensionalultrasoundparametersandSWEparameters forvarious muscles were evaluated byintra-class correlationcoeffcient（ICC）.ResultsComparedwiththehealthygroup，the thicknessandcross-sectionalareaofbilateral multifidus，rectorspinaemuscle，andthe thicknessof transverseabdominal muscleweredecreasedintheobservationgroup，whiletheSWVofbilateralmultifidus，erectorspinaeandtransverseabdominal muscles were increased，the differenceswere statistically significant（all P <0.05）.The consistency analysis showed good agreement of inter-bserver measurementsof thethickness，ross-sectionalarea，andSWVof themultifidusmuscle（ICCformultifidus thickness was 0.928，ICC for multifidus cross-sectionalarea was0.919，ICC for multifidusSWVwas 0.903，all P <0.001）and the erectorspinae muscle（ICCforerectorspinaethicknesswas0.906，ICCforerectorspinaecross-sectionalarea was0.89，ICCfor erector spinae SWV was 0.925，all P<0.001 ）. The agreement in measuring the thickness and SWV of the transversus abdominis muscle was excellent（ICC=0.954，0.964，both P<0.001 ）.ConclusionTwo-dimensional ultrasound and SWE can accurately evaluate the skeletal musclechanges in patients with chronic low back pain，which have acertain clinical value. KEY WORDSUltrasonography，two-dimensional;Shear wave elastography;Chronic low back pain;Skeletal muscle

慢性腰痛的发病率约占全球范围内腰痛的 23% ，具有病程迁延、反复发作的特点，可导致患者无法正常工作、学习，影响其生活质量[1-2]。（剩余6092字）