实时剪切波弹性成像技术对A型肉毒毒素治疗扭转型痉挛性斜颈的应用评价
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摘要
目的探讨实时剪切波弹性成像评价A型肉毒毒素治疗扭转型痉挛性斜颈疗效的临床应用价值。方法选取扭转型痉挛性斜颈患者46例(观察组)及健康志愿者50例(对照组),观察组进行A型肉毒毒素治疗,于治疗前及治疗后2周进行Tsui评分,同时应用实时剪切波超声弹性成像技术测量观察组及对照组的胸锁乳突肌、头夹肌杨氏模量值,对2组结果进行统计分析。结果观察组治疗后Tsui评分较治疗前下降(P <0. 01),治疗后胸锁乳突肌、头夹肌杨氏模量值较治疗前下降,差异有统计学意义(P <0. 01),与对照组同名肌比较,差异有统计学意义(P <0. 01)。结论实时剪切波超声弹性成像技术有助于评价A型肉毒毒素治疗扭转型痉挛性斜颈肌痉挛的疗效。
Objective To investigate the clinical application value of real-time shear wave elastography in evaluating clinical efficiacy of type A botulinum toxin in treatment of torsional spastic torticollis. Methods A total of 46 patients with torsional spastic torticollis were enrolled as observation group,and 50 healthy volunteers were enrolled as control group. The patients in observation group were treated by type A botulinum toxin,and Tsui score was performed before treatment and at 2weeks after treatment. Meanwhile the Young's modulus values of sternocleidomastoid and splenius capitis were detected by real-time shear wave elastography,and the results were statistically analyzed and compared between the two groups. Results After treatment the Tsui scores in observation group were significantly decreased( P < 0. 01),and the Young's modulus values of sternocleidomastoid and splenius capitis were significantly decreased( P < 0. 01),there were significant differences between observation group and control group( P < 0. 01). Conclusion The real-time shear wave elastography is helpful to evaluate the clinical efficiacy of type A botulinum toxin in treatment of torsional spastic torticollis.
Objective To investigate the clinical application value of real-time shear wave elastography in evaluating clinical efficiacy of type A botulinum toxin in treatment of torsional spastic torticollis. Methods A total of 46 patients with torsional spastic torticollis were enrolled as observation group,and 50 healthy volunteers were enrolled as control group. The patients in observation group were treated by type A botulinum toxin,and Tsui score was performed before treatment and at 2weeks after treatment. Meanwhile the Young's modulus values of sternocleidomastoid and splenius capitis were detected by real-time shear wave elastography,and the results were statistically analyzed and compared between the two groups. Results After treatment the Tsui scores in observation group were significantly decreased( P < 0. 01),and the Young's modulus values of sternocleidomastoid and splenius capitis were significantly decreased( P < 0. 01),there were significant differences between observation group and control group( P < 0. 01). Conclusion The real-time shear wave elastography is helpful to evaluate the clinical efficiacy of type A botulinum toxin in treatment of torsional spastic torticollis.
引文
1 Jankovic J,Leder S,Warner D,et al.Cervical dystonia-clinical findings and associated movement disorders.Neurology,1991,41:1088-1091.
2 Simpson DM,Blitzer A,Brashear A,et al.Assessmen:bot-ulinum neurotoxin for the treatment of movement disdorers(an evidence-based review):report of the therapeutics and tcehnology assessment subcommittee of the american academy of neurology.Neurology,2008,70:1699-1706.
3王琳,万新华.对《肌张力障碍诊断与治疗指南》的解读.中国现代神经疾病杂志,2009,9:216-220.
4 Consky E,Lang A.Clinical assessments of patients with cervical dystonia.In Therapy with Botulinum Toxin.Edited by:Jankovic J,Hallett M.New York:Marcel Dekker,Inc,1994.211-237.
5 Tsut JK,Eisen A,Stoessl AJ,et al.Double-blind study of botulinum toxin in spasmodic torticollis.Lancet,1986,2:245-247.
6 Chowdhury RH,Reaz MB,Alia MA,et al.Surface electromyography signal processing and classifiction techniques.Sensors(Basel,Switzerland),2013,13:12431-12466.
7 Gennisson JL,Deffieus T,Mace E,et al.Viscoelastic and anisotropic mechanical properties of in vivo muscle tissue assesed by supersonic shear imaging.ultrasound Med Biol,2010,36:789-801.
8 Brandenburg JE,Eby SF,Song P,et al.Quantifying passive muscle stiffness in children with and without cerebral palsy using ultrasound shear wave elastography.Dev Med Child Neurol,2016,58:1288-1294.
9 Dubois G,Kheireddine W,Vergari C,et al.Reliable protocol for shear wave elastography of lower limb muscles at rest and during passive stretching.Ultrasound Med Biol,2015,41:2284-2291.
10 Devon I.Rubin,Needle Electromyography:Basic Concepts and Patterns of Abnormalities.Neurol Clin,2012,30:429-456.
11 Nijmeijer SW,Koelman JH,Kamphuis DJ,et al.Muscle selection for treatment of cervical dystonia with botulinum toxin-a systematic review.Park.Relat.Disord,2012,18:731-736.
12李良才,唐秉航,何亚奇,等.痉挛性斜颈的CT表现及其诊断价值.放射性实践,2008,23:1197-1120.
13 Brandenburg JE,Eby SF,Song P,et al.Ultrasound Elastography:the New Frontier in Direct Measurement of Muscle Stiffness.Archives of Physical Medicine and Rehabilitation,2014,95:2207-2219.
14 Brandenburg JE,Eby SF,Song P,et al.Feasibility and Reliability of Quantifying Passive Muscle Stiffness in Young Children by Using Shear Wave Ultrasound Elastography.J Ultrasound Med,2015,34:663-670.
15 Lacourpaille L,Hug F,Bouillard K,et al.Supersonic shear imaging provides a reliable measurement of resting muscle shear elastic modulus.Physiol Meas,2012,33:N19-28.
16 Rosskopf AB,Ehrmann C,Buck FM,et al.Quantitative shear-wave USelastography of the supraspinatus muscle:reliability of the method and relation to tendon integrity and muscle quality.Radiology,2016,278:465-474.
17姜镔,王学梅,王学忠,等.实时剪切波弹性成像测量胸锁乳突肌杨氏模量时声束平面与肌束不同角度对测量值的影响.中国医学影像技术,2014,30:269-272.
2 Simpson DM,Blitzer A,Brashear A,et al.Assessmen:bot-ulinum neurotoxin for the treatment of movement disdorers(an evidence-based review):report of the therapeutics and tcehnology assessment subcommittee of the american academy of neurology.Neurology,2008,70:1699-1706.
3王琳,万新华.对《肌张力障碍诊断与治疗指南》的解读.中国现代神经疾病杂志,2009,9:216-220.
4 Consky E,Lang A.Clinical assessments of patients with cervical dystonia.In Therapy with Botulinum Toxin.Edited by:Jankovic J,Hallett M.New York:Marcel Dekker,Inc,1994.211-237.
5 Tsut JK,Eisen A,Stoessl AJ,et al.Double-blind study of botulinum toxin in spasmodic torticollis.Lancet,1986,2:245-247.
6 Chowdhury RH,Reaz MB,Alia MA,et al.Surface electromyography signal processing and classifiction techniques.Sensors(Basel,Switzerland),2013,13:12431-12466.
7 Gennisson JL,Deffieus T,Mace E,et al.Viscoelastic and anisotropic mechanical properties of in vivo muscle tissue assesed by supersonic shear imaging.ultrasound Med Biol,2010,36:789-801.
8 Brandenburg JE,Eby SF,Song P,et al.Quantifying passive muscle stiffness in children with and without cerebral palsy using ultrasound shear wave elastography.Dev Med Child Neurol,2016,58:1288-1294.
9 Dubois G,Kheireddine W,Vergari C,et al.Reliable protocol for shear wave elastography of lower limb muscles at rest and during passive stretching.Ultrasound Med Biol,2015,41:2284-2291.
10 Devon I.Rubin,Needle Electromyography:Basic Concepts and Patterns of Abnormalities.Neurol Clin,2012,30:429-456.
11 Nijmeijer SW,Koelman JH,Kamphuis DJ,et al.Muscle selection for treatment of cervical dystonia with botulinum toxin-a systematic review.Park.Relat.Disord,2012,18:731-736.
12李良才,唐秉航,何亚奇,等.痉挛性斜颈的CT表现及其诊断价值.放射性实践,2008,23:1197-1120.
13 Brandenburg JE,Eby SF,Song P,et al.Ultrasound Elastography:the New Frontier in Direct Measurement of Muscle Stiffness.Archives of Physical Medicine and Rehabilitation,2014,95:2207-2219.
14 Brandenburg JE,Eby SF,Song P,et al.Feasibility and Reliability of Quantifying Passive Muscle Stiffness in Young Children by Using Shear Wave Ultrasound Elastography.J Ultrasound Med,2015,34:663-670.
15 Lacourpaille L,Hug F,Bouillard K,et al.Supersonic shear imaging provides a reliable measurement of resting muscle shear elastic modulus.Physiol Meas,2012,33:N19-28.
16 Rosskopf AB,Ehrmann C,Buck FM,et al.Quantitative shear-wave USelastography of the supraspinatus muscle:reliability of the method and relation to tendon integrity and muscle quality.Radiology,2016,278:465-474.
17姜镔,王学梅,王学忠,等.实时剪切波弹性成像测量胸锁乳突肌杨氏模量时声束平面与肌束不同角度对测量值的影响.中国医学影像技术,2014,30:269-272.