Kristjansson Eythor
Health Sciences at the Faculty of Medicine, The University of Iceland, Skildinganes 36, Reykjavík, IS-101, Iceland.
Man Ther. 2004 May;9(2):83-8. doi: 10.1016/S1356-689X(03)00059-6.
A test-retest and inter-tester study was designed to assess the reliability of ultrasonography to depict the size of the cervical multifidus muscle in asymptomatic and symptomatic subjects. Ten asymptomatic women (range 19-48 years) and 10 women with chronic whiplash associated disorder (WAD), grade II, (range 19-49 years), matched for height and weight participated. The women were imaged by ultrasonography on two separate occasions by two different testers. On each occasion the cross-sectional area (CSA), and the transverse versus the anterior-posterior dimensions (shape ratio) at the C4 level were measured. The repeated measurements of the CSA were plotted against their means to reveal the limit of agreement. Good agreement was found for the asymptomatic group measurements and the intra-tester agreement for the symptomatic group. The inter-tester agreement for the symptomatic group was questionable. The size of the multifidus muscle was significantly reduced in the symptomatic group ( P<0.05 ). The results indicate that loss of clarity of the fascial layer between the semispinalis cervicis muscle and the cervical multifidus muscle may be a diagnostic sign of muscle atrophy. Ultrasonography can be used to precisely measure the size of the cervical multifidus muscle at the C4-level in asymptomatic young female subjects; it is also reliable for symptomatic subjects if the same tester performs the measurements. Additional criteria are recommended to improve the inter-tester agreement for symptomatic subjects.
一项重测和测试者间研究旨在评估超声检查描绘无症状和有症状受试者颈多裂肌大小的可靠性。纳入了10名无症状女性（年龄范围19 - 48岁）和10名患有慢性挥鞭样损伤相关疾病（WAD）II级的女性（年龄范围19 - 49岁），她们在身高和体重方面相匹配。这些女性由两名不同的测试者在两个不同时间进行超声成像。每次均测量C4水平的横截面积（CSA）以及横径与前后径之比（形状比）。将CSA的重复测量值与其均值作图以显示一致性界限。在无症状组测量中发现一致性良好，有症状组中测试者内一致性良好。有症状组中测试者间一致性存在疑问。有症状组的多裂肌大小显著减小（P<0.05）。结果表明，颈半棘肌和颈多裂肌之间筋膜层清晰度的丧失可能是肌肉萎缩的诊断标志。超声检查可用于精确测量无症状年轻女性受试者C4水平颈多裂肌的大小；如果由同一测试者进行测量，对有症状受试者也可靠。建议采用额外标准以提高有症状受试者的测试者间一致性。
