Department of Radiology, University Hospital, Zurich, Switzerland.
J Magn Reson Imaging. 2012 Dec;36(6):1413-20. doi: 10.1002/jmri.23769. Epub 2012 Aug 3.
To investigate the role of the cervical spine muscles in whiplash injury. We hypothesized that (i) cervical muscle hypotrophy would be evident after a 6-month follow-up and, (ii) cervical muscle hypotrophy would correlate with symptom persistence probably related to pain or inactivity.
Ninety symptomatic patients (48 females) were recruited from our emergency department and examined within 48 h, and at 3, and 6 months after a motor vehicle accident. MRI cross-sectional muscle area (CSA) measurements were performed bilaterally of the cervical extensor and sternocleidomastoid muscles using transverse STIR (Short Tau inversion Recovery) sequences at the C2 (deep and total dorsal cervical extensor muscles), C4 (sternocleidomastoid muscles) and C5 (deep and total dorsal cervical extensor muscles) levels. Two blinded raters independently performed the measurements at each time point. First, CSA changes over time were analyzed and, second, CSAs were correlated with clinical outcomes (EuroQuol, Whiplash Disability Score, neck pain intensity [VAS], cervical spine mobility).
There was a high agreement of CSA measurements between the two raters. Women consistently had smaller CSAs than men. There were no significant changes of CSAs over time at any of the three levels. There were no consistent significant correlations of CSA values with the clinical scores at all time points except with the body mass index.
Our results do not support a major role of cervical muscle volume in the genesis of symptoms after whiplash injury.
研究颈椎肌肉在挥鞭伤中的作用。我们假设：（i）在 6 个月的随访后，颈椎肌肉萎缩会明显；（ii）颈椎肌肉萎缩与症状持续存在相关，可能与疼痛或不活动有关。
90 名有症状的患者（48 名女性）从我们的急诊部招募，并在机动车事故后 48 小时内、3 个月和 6 个月进行检查。使用 C2（深部和总颈伸肌）、C4（胸锁乳突肌）和 C5（深部和总颈伸肌）水平的横断 STIR（短 tau 反转恢复）序列对双侧颈伸肌和胸锁乳突肌进行 MRI 横截面积（CSA）测量。两位盲法评估员在每个时间点独立进行测量。首先，分析 CSA 随时间的变化，其次，分析 CSA 与临床结果（EuroQuol、挥鞭伤残疾评分、颈痛强度[VAS]、颈椎活动度）的相关性。
两位评估员之间 CSA 测量的一致性很高。女性的 CSA 始终小于男性。在三个水平上，CSA 均无随时间的显著变化。除了体重指数外，在所有时间点，CSA 值与临床评分均无一致的显著相关性。
我们的结果不支持颈椎肌肉体积在挥鞭伤后症状发生中的主要作用。
