多模态超声成像在脑卒中患者腓肠肌痉挛评估中的应用

doi:10.3969/j.issn.1006-9771.2021.07.009

Abstract

Abstract:

Objective To apply multimodal ultrasound imaging in spasticity assessment for stroke patients with hemiplegia.

Methods From March to September, 2019, 44 inpatients with lower limb spastic hemiplegia after stroke (patients) and 46 healthy volunteers (controls) were scanned with two-dimensional ultrasound imaging, shear wave elastography and super microvascular imaging at the same area of gastrocnemius muscle of both sides of patients and right side of controls, in resting and maximum isometric contraction. The parameters of shear wave velocity (SWV), blood flow signal, pinnation angle (PA), fascicle length (FL) and muscle thickness (MT) were recorded.

Results SWV increased in the affected side of the patients compared with those of the unaffected side and controls in resting (t > 6.346, P < 0.01), while FL shortened (|t| > 6.235, P < 0.01), MT and PA changed compared with those of the unaffected side (|t| > 2.198, P < 0.05), and blood flow signal decreased compared with those of the controls (t = 2.604, P < 0.05). In maximum isometric contraction, the decrease of FL was less compared with those of the unaffected side and controls (Z > 6.703, P < 0.001).

Conclusion Ultrasound imaging can quantitatively evaluate spasticity of gastrocnemius muscle for patients with stroke in terms of morphological structure, blood flow, and muscle stiffness.

Key words: stroke, spasticity, ultrasound, muscular tension, assessment

CLC Number:

R743.3

CHEN Ming-zhen,JIANG Fan,SHAN Yong,HONG Yong-feng,LIU Xue,XIAO Hong-bo,CHEN Rui-quan. Measurement of Structure and Stiffness of Gastrocnemius Muscle for Stroke Patients with Multimodal Ultrasound Imaging[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(7): 791-796.

Figures/Tables 6

References 41

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组别	n	性别(男/女, n)	年龄(岁)	类型(出血/梗死, n)	偏瘫侧(左/右,n)
对照组	46	32/14	53.83±10.25
试验组	44	33/11	53.43±13.54	29/15	25/19
χ²/t值		0.156	0.331
P值		0.876	0.565

组别	n	FL(mm)	MT(mm)	PA(°)	SWV(m/s)	SMI(%)
对照组	46	48.05±2.15	13.75±2.68	13.07±3.23	2.69±0.40	7.49±2.11
试验组健侧	44	47.69±3.31	11.14±2.55	12.02±2.93	2.72±0.56
试验组患侧	44	43.22±3.40	12.25±2.21	14.64±3.18	3.70±0.85	6.28±2.31
t₁值		-6.235	2.198	4.006	6.346
P₁值		< 0.001	0.031	<0.001	< 0.001
t₂值		-8.073	-2.881	2.326	7.119	2.604
P₂值		< 0.001	0.005	0.022	< 0.001	0.011

组别	n	差值
对照组	46	10.91±4.23
试验组健侧	44	9.10±4.06
试验组患侧	44	3.52±1.94
Z₁值		2.055
P₁值		0.040
Z₂值		6.703
P₂值		< 0.001
Z₃值		7.318
P₃值		< 0.001

Measurement of Structure and Stiffness of Gastrocnemius Muscle for Stroke Patients with Multimodal Ultrasound Imaging

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