Pillen Sigrid, Boon Andrea, Van Alfen Nens
Department of Sleep Medicine, Kempenhaeghe Expertise Center for Epileptology, Sleep Medicine and Neurocognition, Heeze, The Netherlands.
Department of Physical Medicine and Rehabilitation and Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Handb Clin Neurol. 2016;136:843-53. doi: 10.1016/B978-0-444-53486-6.00042-9.
Muscle ultrasound is an ideal imaging modality that allows for noninvasive, radiation-free point-of-care neuromuscular imaging. There are many potential applications of muscle ultrasound, including identification of abnormal muscle movements such as fasciculations, evaluation of muscle trauma, identification of physiologic parameters such as pennation angle, accurate performance of chemodenervation, and improved accuracy of challenging electrodiagnostic studies such as phrenic nerve conduction studies or needle electromyogram (EMG) of the diaphragm. Tissue Doppler imaging can be used to help identify inflammatory myopathies. With computer-assisted quantification, muscle ultrasound has high sensitivity and specificity in the diagnosis of pediatric neuromuscular disease and amyotrophic lateral sclerosis, and is a valuable addition to other diagnostic techniques for neuromuscular disease. When used as a first-line screening tool it can obviate the need for more invasive procedures such as EMG or muscle biopsy in certain patients. This chapter provides an overview of the fundamentals, clinical applications, and validation of muscle ultrasound for patients with neuromuscular disorders.
肌肉超声是一种理想的成像方式，可实现无创、无辐射的床旁神经肌肉成像。肌肉超声有许多潜在应用，包括识别异常肌肉运动（如肌束震颤）、评估肌肉创伤、识别生理参数（如羽状角）、准确进行化学去神经支配以及提高具有挑战性的电诊断研究（如膈神经传导研究或膈肌针极肌电图[EMG]）的准确性。组织多普勒成像可用于帮助识别炎性肌病。通过计算机辅助定量分析，肌肉超声在诊断儿童神经肌肉疾病和肌萎缩侧索硬化症方面具有高灵敏度和特异性，是神经肌肉疾病其他诊断技术的重要补充。当用作一线筛查工具时，它可以避免某些患者进行更具侵入性的检查，如肌电图或肌肉活检。本章概述了肌肉超声在神经肌肉疾病患者中的基本原理、临床应用及验证情况。
