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肌肉超声评分在肌萎缩侧索硬化症诊断中的应用

A muscle ultrasound score in the diagnosis of amyotrophic lateral sclerosis.

作者信息

Tsuji Yukiko, Noto Yu-Ichi, Shiga Kensuke, Teramukai Satoshi, Nakagawa Masanori, Mizuno Toshiki

机构信息

Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

出版信息

Clin Neurophysiol. 2017 Jun;128(6):1069-1074. doi: 10.1016/j.clinph.2017.02.015. Epub 2017 Mar 1.

Abstract

OBJECTIVE

The aims of this study are to elucidate the frequencies and distribution of fasciculations using muscle ultrasound in patients with amyotrophic lateral sclerosis (ALS) and those with other conditions mimicking ALS, and subsequently to develop a novel fasciculation score for the diagnosis of ALS.

METHODS

Ultrasound of 21 muscles was performed to detect fasciculations in 36 consecutive patients suspected of having ALS. We developed a fasciculation ultrasound score that indicated the number of muscles with fasciculations in statistically selected muscles.

RESULTS

A total of 525 muscles in 25 ALS patients and 231 in 11 non-ALS patients were analysed. Using relative operating characteristic and multivariate logistic regression analysis, we selected the trapezius, deltoid, biceps brachii, abductor pollicis brevis, abdominal, vastus lateralis, vastus medialis, biceps femoris, and gastrocnemius muscles for the fasciculation ultrasound score. The mean scores were higher in the ALS group than those in the non-ALS group (5.3±0.5vs. 0.3±0.7) (mean±SD); p<0.001.

CONCLUSIONS

Two or more of the fasciculation ultrasound scores showed high sensitivity and specificity in differentiating ALS patients from non-ALS patients.

SIGNIFICANCE

The fasciculation ultrasound score can be a simple and useful diagnostic marker of ALS.

摘要

目的

本研究旨在阐明肌萎缩侧索硬化症(ALS)患者及其他疑似ALS疾病患者中肌束震颤的频率和分布情况,并随后开发一种用于ALS诊断的新型肌束震颤评分系统。

方法

对36例疑似患有ALS的连续患者的21块肌肉进行超声检查以检测肌束震颤。我们开发了一种肌束震颤超声评分系统,该系统可显示在经统计学选择的肌肉中出现肌束震颤的肌肉数量。

结果

共分析了25例ALS患者的525块肌肉和11例非ALS患者的231块肌肉。通过相对操作特征和多变量逻辑回归分析,我们选择了斜方肌、三角肌、肱二头肌、拇短展肌、腹部肌肉、股外侧肌、股内侧肌、股二头肌和腓肠肌用于肌束震颤超声评分。ALS组的平均评分高于非ALS组(5.3±0.5对0.3±0.7)(平均值±标准差);p<0.001。

结论

肌束震颤超声评分中的两项或更多项在区分ALS患者和非ALS患者方面显示出高敏感性和特异性。

意义

肌束震颤超声评分可成为一种简单且有用的ALS诊断标志物。

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