超声多参数成像评价腰部多裂肌损伤的前瞻性临床研究  

Evaluation of lumbar multifidus muscle injury using ultrasound multi-feature:a prospective study

作　　者：张超 毛译 王雁 袁林 孙豪 李盈盈 毛鹏[2] 朱谦[2] 张明博 闫龙涛[2] ZHANG Chao;MAO Yi;WANG Yan;YUAN Lin;SUN Hao;LI Ying-ying;MAO Peng;ZHU Qian;ZHANG Ming-bo;YAN Long-tao(Department of Ultrasound,the First Medical Center,General Hospital of Chinese PLA,Beijing 100853,China;Department of Pain Medicine,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中国人民解放军总医院第一医学中心超声诊断科,北京100853 [2]中日友好医院疼痛科,北京100029

出　　处：《中国疼痛医学杂志》2024年第6期432-438,共7页Chinese Journal of Pain Medicine

基　　金：国家自然科学基金(82071924)。

摘　　要：目的:应用超声多参数成像评估慢性腰痛病人与无症状者腰部多裂肌超声影像特征。方法:2022年3月至2023年8月前瞻性纳入慢性腰痛病人(腰痛组)与无症状志愿者(无症状组)各60人,由2位超声医师分别测量受试者多裂肌厚度、面积,L3筋膜厚度以及多裂肌弹性模量。分析上述参数的一致性、随腰椎节段的变化趋势,以及两组之间的差异。结果:上述超声参数具有良好的一致性。随着腰椎节段的增加,多裂肌的厚度和面积均不断增加。腰痛组与无症状组相比,L3~4、L4~5多裂肌厚度显著减低,L2~3、L3~4、L4~5多裂肌面积显著减低;L3筋膜厚度及多裂肌弹性显著增加。结论:腰痛病人腰部多裂肌超声影像特征可发生明显变化,提示腰部多裂肌损伤可能是导致腰痛的重要原因。Objective:To evaluate the ultrasound(US)characteristics of lumbar multifidus muscle in patients with chronic low back pain and asymptomatic volunteers by multi-parameter imaging.Methods:From March 2022 to August 2023,sixty patients with chronic low back pain and sixty asymptomatic volunteers(asymptomatic group)were prospectively enrolled in our study.The thickness and area of the multifidus muscle,the thickness of the L3 fascia and the elastic modulus of the multifidus muscle were measured by two sonographers.The consistency of the above features and the change trend of different lumbar vertebral segments were evaluated,and the differences of the US features were compared between the two groups.Results:The ultrasound features were good of consistency.With the continuous increase of lumbar segments,the thickness and area of the multifidus muscle increased.Compared with the asymptomatic group,the thickness of L3~4,L4~5 multifidus muscle and the area of L2~3,L3~4,L4~5 multifidus muscle were significantly reduced,L3 fascia thickness was significantly increased and the multifidus muscle elasticity was significantly increased in the low back pain group.Conclusion:The ultrasonic features of lumbar multifidus muscle can be significantly changed in patients with low back pain,suggesting that lumbar multifidus muscle injury may be an important cause of low back pain.

关 键 词：腰痛 多裂肌 视觉模拟评分法 超声 弹性 

分 类 号：R681.55[医药卫生—骨科学]