Lee Jo-Ping, Tseng Wen-Yih I, Shau Yio-Wha, Wang Chung-Li, Wang Hsing-Kuo, Wang Shwu-Fen
School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Zhongzheng District, Taipei City, Taipei, Taiwan, ROC.
Man Ther. 2007 Aug;12(3):286-94. doi: 10.1016/j.math.2006.07.008. Epub 2006 Sep 20.
The deep muscles that play significant roles in maintaining segmental stability have been measured using ultrasonography (US). However, few studies have been carried out to determine the reliability and validity of US for measuring the cervical multifidus during contraction. The aims of this investigation were to evaluate the reliability of the dimensions of the cervical multifidus as measured using US and compare the US measurements with those determined with magnetic resonance imaging (MRI), the gold standard. Ten asymptomatic adult subjects (age, 28.5+/-3.5 years) participated in testing-retesting of muscle dimensions at rest and during isometric head extension with the cranio-cervical spine maintained in a flexed position against individual maximum resistance. Ten asymptomatic adult subjects (age, 28.1+/-4.1 years) participated in testing to compare US and MRI measurements of the thickness, width, area, and shape ratio of the cervical multifidus at the C4, C5, and C6 levels. US measurements of muscle thickness at the C4, C5, and C6 levels at rest were 0.67+/-0.14, 0.70+/-0.20 and 0.73+/-0.09 cm, respectively; the corresponding measurements as determined by MRI were 0.70+/-0.12, 0.67+/-0.15 and 0.70+/-0.06 cm. The within-subject coefficient of variation (CV(w)) for thickness at rest and during contraction was less than 10%, indicating acceptable reliability. US measurement of thickness had better reliability and validity. The range of limit of agreement for muscle thickness at the C4, C5, and C6 levels was -0.20 to 0.20 cm, and the range of R(2) was 0.42-0.64. The thickness of the cervical multifidus muscle increased significantly during contraction (1.13+/-0.20, 1.19+/-0.20 and 1.17+/-0.12 cm for the C4, C5, and C6 levels, P<0.05). However, no significant differences were noted among the three levels. The results indicate that US can detect changes in segmental cervical multifidus during contraction.
利用超声检查（US）对在维持节段稳定性中起重要作用的深层肌肉进行了测量。然而，很少有研究来确定US测量颈椎多裂肌收缩时的可靠性和有效性。本研究的目的是评估使用US测量颈椎多裂肌尺寸的可靠性，并将US测量结果与磁共振成像（MRI）（金标准）确定的结果进行比较。10名无症状成年受试者（年龄28.5±3.5岁）参与了在休息时以及在颅颈椎保持屈曲位对抗个体最大阻力进行等长头部伸展时肌肉尺寸的重测。10名无症状成年受试者（年龄28.1±4.1岁）参与了测试，以比较US和MRI对C4、C5和C6水平颈椎多裂肌厚度、宽度、面积和形状比的测量。休息时C4、C5和C6水平肌肉厚度的US测量值分别为0.67±0.14、0.70±0.20和0.73±0.09 cm；MRI确定的相应测量值分别为0.70±0.12、0.67±0.15和0.70±0.06 cm。休息时和收缩时厚度的受试者内变异系数（CV(w)）小于10%，表明可靠性可接受。US测量厚度具有更好的可靠性和有效性。C4、C5和C6水平肌肉厚度的一致性界限范围为-0.20至0.20 cm，R(2)范围为0.42 - 0.64。颈椎多裂肌厚度在收缩时显著增加（C4、C5和C6水平分别为1.13±0.20、1.19±0.20和1.17±0.12 cm，P<0.05）。然而，三个水平之间未发现显著差异。结果表明，US能够检测到颈椎多裂肌在收缩时的节段性变化。
