剪切波弹性成像对脑卒中后足内翻腓肠肌A型肉毒素注射后硬度变化的定量评估  

作　　者：徐小伟[1] 蔡洁[1] 张云姣[1] 郑宁[1] 

机构地区：[1]浙江省金华市人民医院,321000

出　　处：《浙江临床医学》2022年第3期434-435,共2页Zhejiang Clinical Medical Journal

基　　金：金华市科技局公益类项目(2020-4-045)。

摘　　要：目的应用实时剪切波弹性成像(SWE)定量评估脑卒中后足内翻患者行A型肉毒素注射后腓肠肌的硬度变化。方法选取脑卒中后足内翻患者48例,注射A型肉毒素治疗,应用SWE观察患者治疗前、治疗4周后静息状态下腓肠肌的杨氏模量变化,同时采用改良Ashworth量表(MAS)进行康复评估,分析超声杨氏模量值与MAS评分的相关性。结果治疗前患侧腓肠肌的杨氏模量高于健侧,差异有统计学意义(P<0.05)。治疗后4周,患侧腓肠肌杨氏模量值降低,与健侧比较差异无统计学意义(P>0.05)。治疗后足内翻侧下肢肌张力MAS评分也明显降低(P<0.05),与超声测量杨氏模量值呈正相关(P<0.05)。结论SWE可定量显示脑卒中后足内翻注射A型肉毒素前后肌肉硬度的变化,能客观评定肌张力的变化,与MAS联合使用可为临床治疗提供更客观的依据。Objective To explore the value of shear wave elastography(SWE)in evaluation on gastrocnemius muscle hardness after injection of botulinum toxin Type A(BTA)for treatment of talipes varus after stroke.Methods 48 patients with varus plantaris after stroke were treated with BTA.The hardness of gastrocnemius muscle was observed by SWE before and after 4 weeks of treatment.The Modified Ashworth Scale(MAS)was used to assess the rehabilitation,and the correlarion between Young's Modulus and MAS score was analyzed.Results Before treatment,the young's modulus of gastrocnemius muscle of the affected side was higher than that of the healthy side(P=0.000).4 weeks after treatment,the young's modulus of the affected gastrocnemius muscle was lower than that before treatment,there was no significant difference between the affected side and healthy side(P=0.496).There was a positive correlation between MAS scores and young's modulus of affected lower limbs before and after treatment.Conclusion SWE can quantitatively display the changes of muscle hardness before and after injection of BTA after stroke,and objectively evaluate the changes of muscle tension,it also can provide more information for clinical treatment when combined with MAS.

关 键 词：实时剪切波成像 脑卒中后足内翻 A型肉毒素腓肠肌 

分 类 号：R44[医药卫生—诊断学]