Gold Judith E, Hallman David M, Hellström Fredrik, Björklund Martin, Crenshaw Albert G, Mathiassen Svend Erik, Barbe Mary F, Ali Sayed
Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
Gold Standard Research Consulting, 830 Montgomery Ave, Bryn Mawr, PA, USA.
BMC Musculoskelet Disord. 2017 Sep 12;18(1):395. doi: 10.1186/s12891-017-1694-y.
This study systematically summarizes quantitative imaging biomarker research in non-traumatic neck and shoulder musculoskeletal disorders (MSDs). There were two research questions: 1) Are there quantitative imaging biomarkers associated with the presence of neck and shoulder MSDs?, 2) Are there quantitative imaging biomarkers associated with the severity of neck and shoulder MSDs?
PubMed and SCOPUS were used for the literature search. One hundred and twenty-five studies met primary inclusion criteria. Data were extracted from 49 sufficient quality studies.
Most of the 125 studies were cross-sectional and utilized convenience samples of patients as both cases and controls. Only half controlled for potential confounders via exclusion or in the analysis. Approximately one-third reported response rates. In sufficient quality articles, 82% demonstrated at least one statistically significant association between the MSD(s) and biomarker(s) studied. The literature synthesis suggested that neck muscle size may be decreased in neck pain, and trapezius myalgia and neck/shoulder pain may be associated with reduced vascularity in the trapezius and reduced trapezius oxygen saturation at rest and in response to upper extremity tasks. Reduced vascularity in the supraspinatus tendon may also be a feature in rotator cuff tears. Five of eight studies showed an association between a quantitative imaging marker and MSD severity.
Although research on quantitative imaging biomarkers is still in a nascent stage, some MSD biomarkers were identified. There are limitations in the articles examined, including possible selection bias and inattention to potentially confounding factors. Recommendations for future studies are provided.
本研究系统总结了非创伤性颈肩肌肉骨骼疾病（MSD）的定量成像生物标志物研究。有两个研究问题：1）是否存在与颈肩MSD存在相关的定量成像生物标志物？2）是否存在与颈肩MSD严重程度相关的定量成像生物标志物？
使用PubMed和SCOPUS进行文献检索。125项研究符合主要纳入标准。数据从49项质量足够的研究中提取。
125项研究中的大多数为横断面研究，将患者的便利样本用作病例和对照。只有一半通过排除或在分析中控制了潜在的混杂因素。约三分之一报告了应答率。在质量足够的文章中，82%表明所研究的MSD与生物标志物之间至少存在一种统计学上显著的关联。文献综述表明，颈部疼痛可能导致颈部肌肉大小减小，斜方肌肌痛以及颈/肩疼痛可能与斜方肌血管减少、静息时以及对上肢任务作出反应时斜方肌氧饱和度降低有关。冈上肌腱血管减少也可能是肩袖撕裂的一个特征。八项研究中的五项显示定量成像标志物与MSD严重程度之间存在关联。
尽管定量成像生物标志物的研究仍处于初期阶段，但已确定了一些MSD生物标志物。所审查的文章存在局限性，包括可能的选择偏倚以及对潜在混杂因素的忽视。提供了对未来研究的建议。
