剪切波弹性成像技术在评价A型肉毒毒素注射咬肌中的应用  

The application of shear wave elastography in the evaluation of type A botulinum toxin injection masseter for face-lift

作　　者：刁雪红[1] 郭妤[1] 陈悦[1] 金佳美[1] 陈璐[1] 詹嘉[1] 

机构地区：[1]复旦大学附属华东医院,上海200040

出　　处：《中国临床医学影像杂志》2017年第5期321-323,共3页Journal of China Clinic Medical Imaging

基　　金：上海市卫生局青年科研项目(No.20124y150)

摘　　要：目的:应用剪切波弹性成像技术(SWE)评估A型肉毒毒素注射咬肌瘦脸的治疗效果。方法 :20例咬肌肥大患者,共40侧咬肌,接受A型肉毒毒素注射前后分别行二维超声及剪切波弹性成像检查,常规超声测量松弛状态和收缩状态下咬肌的厚度,SWE于两种状态下评估咬肌硬度,通过随访记录注射前、注射后1周、1月、3月、6月的各项指标,评价SWE在A型肉毒毒素注射咬肌中治疗效果评估的价值。结果:A型肉毒毒素注射后1周开始,无论是松弛状态还是收缩状态下咬肌厚度均减小,硬度减低,3月随访测量变化最明显,咬肌厚度明显缩小,松弛状态下平均缩小约22.2%±4.2%,收缩状态下平均缩小约22.8%±5.3%,肌硬度也明显下降,松弛状态下杨氏模量值平均缩小约19.5%±3.4%,收缩状态下平均缩小约60.4%±5.8%,6月时厚度及硬度开始恢复。结论:SWE用于动态观察咬肌的肌张力,结合其厚度变化,定量评价A型肉毒毒素注射瘦脸的药物疗效,为二次注射提供最佳的时间与剂量参考。Objective： To assess the value of shear wave elastography （SWE） in the evaluation of type A botulinum toxin injection masseter for face-lift. Methods： 20 patients injected type A botulinum toxin in masseter. All the patients were ex- amined by two-dimensional ultrasound and SWE. These two imagine methods measured the thickness and hardness of masseter under the relaxation state and forced occlusal status before injection, and after 1 week, 1 month, 3 months, 6 months. Result： Started 1 week after injection of type A botulinum toxin, the thickness and hardness of masseter muscle were decreased under both relaxation and occlusal condition. Those changes were obvious at 3 months, the mean reduction of relaxation masseter muscle thickness were 22.2%±4.2%, contraction thickness were 22.8%±5.3%, muscle strength was also significantly decreased, the mean reduction of relaxation strength were 19.5%±3.4%, contraction strength were 60.4%±5.8%, the thickness and hard- ness began to recover on 6 month. Conclusion： SWE and B-ultrasound could effectively reflect the rednction of muscle thickness and herdness after type A botulinum toxin injection. It could provide the best time and dose reference for the second injection.

关 键 词：肉毒毒素类 咬肌 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学]