超声应变成像评估慢性脑卒中后痉挛状态下的肱二头肌
Ultrasound Strain Imaging to Assess the Biceps Brachii Muscle in Chronic Poststroke Spasticity.
作者信息
Gao Jing, Chen Johnson, O'Dell Michael, Li Pai-Chi, He Wen, Du Li-Juan, Rubin Jonathan M, Weitzel William, Min Robert
机构信息
Department of Radiology, Weill Cornell Medicine, New York, New York, USA.
Rocky Vista University, Ivins, Utah, USA.
出版信息
J Ultrasound Med. 2018 Aug;37(8):2043-2052. doi: 10.1002/jum.14558. Epub 2018 Feb 5.
OBJECTIVES
The aim of the study was to assess the feasibility of ultrasound strain imaging in characterizing the biceps brachii muscle in chronic poststroke spasticity.
METHODS
We prospectively analyzed strain imaging data from bilateral biceps brachii muscles in 8 healthy volunteers and 7 patients with poststroke chronic spasticity. Axial deformations of the biceps brachii muscle and overlying subcutaneous tissue were produced by external compression using a sandbag (1.0 kg) attached to a transducer. The lengthening and shortening of the biceps brachii muscle and subcutaneous tissue were produced by manual passive elbow extension (from 90° to 0°) and flexion (from 0° to 90°), respectively. We used offline 2-dimensional speckle tracking to estimate axial and longitudinal strain ratios (biceps brachii strain/subcutaneous tissue strain), and the longitudinal tissue velocity of the biceps brachii muscle. Statistical analyses included analysis of variance for testing differences in strain imaging parameters among healthy, nonspastic, and spastic biceps brachii muscles, the Bonferroni correction for further testing differences in US strain imaging among paired groups (healthy versus spastic, nonspastic versus spastic, and healthy versus nonspastic), and the Pearson correlation coefficient for assessing the intraobserver reliability of performing strain imaging in stroke survivors.
RESULTS
The differences in strain imaging parameters between healthy and spastic and between nonspastic and spastic biceps brachii muscles were significant at both 90° elbow flexion and maximal elbow extension (P < .01). There was no significant difference in axial strain ratios at 90° of elbow flexion or longitudinal tissue velocities between healthy and nonspastic muscles (P > .05). The intraobserver reliability of performing strain imaging in stroke survivors was good (r = 0.85; P < .01).
CONCLUSIONS
Ultrasound strain imaging seems to be feasible for characterizing the biceps brachii muscle in chronic poststroke spasticity.
目的
本研究旨在评估超声应变成像在表征慢性脑卒中后痉挛肱二头肌方面的可行性。
方法
我们前瞻性分析了8名健康志愿者和7名脑卒中后慢性痉挛患者双侧肱二头肌的应变成像数据。使用连接在换能器上的沙袋（1.0 kg）进行外部压迫，以产生肱二头肌和覆盖的皮下组织的轴向变形。分别通过手动被动伸肘（从90°到0°）和屈肘（从0°到90°）来产生肱二头肌和皮下组织的伸长和缩短。我们使用离线二维散斑追踪来估计轴向和纵向应变比（肱二头肌应变/皮下组织应变）以及肱二头肌的纵向组织速度。统计分析包括方差分析，用于测试健康、非痉挛和痉挛肱二头肌之间应变成像参数的差异；Bonferroni校正，用于进一步测试配对组（健康与痉挛、非痉挛与痉挛、健康与非痉挛）之间超声应变成像的差异；以及Pearson相关系数，用于评估在脑卒中幸存者中进行应变成像的观察者内可靠性。
结果
在肘屈曲90°和最大肘伸展时，健康与痉挛以及非痉挛与痉挛肱二头肌之间的应变成像参数差异均具有统计学意义（P < 0.01）。在肘屈曲90°时的轴向应变比或健康与非痉挛肌肉之间的纵向组织速度方面，差异无统计学意义（P > 0.05）。在脑卒中幸存者中进行应变成像的观察者内可靠性良好（r = 0.85；P < 0.01）。
结论
超声应变成像似乎可用于表征慢性脑卒中后痉挛的肱二头肌。
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