目的 探讨应用超声弹性成像技术定量评价脑卒中后前臂屈肌痉挛的可行性及其特点。方法 2019年1月至10月,脑卒中后屈腕和屈指肌痉挛的住院患者30例,采用超声弹性成像测量前臂屈肌群桡侧腕屈肌(FCR)、尺侧腕屈肌(FCU)、指浅屈肌(FDS)和指深屈肌(FDP)剪切波速度(SWV),采用改良Ashworth量表(MAS)评定屈腕和屈指肌张力。结果 患侧和健侧各肌肉SWV在牵伸位时均显著高于放松位(|Z| > 3.844, P< 0.001);牵伸位时,患侧各肌肉SWV显著高于健侧(|Z| > 3.593, P< 0.001);牵伸位与放松位SWV差值比较,患侧各肌肉明显高于健侧(t> 3.199,P< 0.01);各肌肉牵伸位平均SWV与屈腕MAS评分显著相关(r= 0.605,P< 0.001);指浅屈肌和与指深屈肌牵伸位平均SWV与屈指MAS评分明显相关(r= 0.540,P< 0.01)。结论 超声弹性成像可以定量评价脑卒中后前臂屈肌群内不同肌肉的痉挛程度。

Objective To apply the ultrasound elastography in quantitative evaluation for spasticity of forearm flexor muscles after stroke, and observe its characteristics. Methods From January to October, 2019, 30 inpatients with stroke were recruited, followning spasticity of wrist and finger flexor muscles. They were measured the shear wave velocity (SWV) of flexor carpi ulnaris (FCU), flexor digitorum superficialis (FDS), flexor digitorum profundus (FDP) and flexor carpi radialis (FCR) with ultrasound elastography, and assessed the tension of wrist and finger flexors with modified Ashworth Scale (MAS).Results The SWV of all the muscles were more in stretching position than in relaxation position in both sides (|Z| > 3.844, P< 0.001). The SWV of all the muscles were more in the affected side than in the unaffected side in stretching position (|Z| > 3.593, P< 0.001). The differences of SWV between stretching and relaxation were more in all the muscles in the affected side than in the unaffected side (t> 3.199,P< 0.01). The mean SWV of all the muscles significantly correlated with the MAS score of wrist (r= 0.605,P< 0.001), while the mean SWV of FDS and FDP correlated with the MAS score of finger (r= 0.540,P< 0.01).Conclusion Ultrasound elastography is useful to quantitatively evaluate the spasticity of each muscle of forearm flexors after stroke.