Creze Maud, Soubeyrand Marc, Yue Jin Long, Gagey Olivier, Maître Xavier, Bellin Marie-France
Radiology Department, Bicêtre Hospital, APHP, France.
Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M, CNRS, Univ Paris-Sud, Université Paris-Saclay, Orsay, France.
Clin Anat. 2018 May;31(4):514-520. doi: 10.1002/ca.23065.
Back pain is associated with increased lumbar paraspinal muscle (LPM) stiffness identified by manual palpation and strain elastography. Recently, magnetic resonance elastography (MRE) has allowed the stiffness of muscle to be characterized noninvasively in vivo, providing quantitative 3D stiffness maps (elastograms). The aim of this study was to characterize the stiffness (shear modulus, SM) of the LPM (multifidus and erector spinae) using MRE. MRE of the lumbar region was performed on seven adults in supine position. MRE was acquired in three muscular states: relaxed with outstretched legs, stretched with passive pelvis flexion, and contracted with outstretched legs and tightened trunk muscles. The mean SM was measured within a region of interest manually defined in the multifidus, erector spinae, and the entire paraspinal compartment. The intermuscular difference and the effects of stretching and contraction were assessed by ANOVA and t-tests. At rest, the mean SM of the paraspinal compartment was 1.6 ± 0.2 kPa. It increased significantly with stretching to 1.65 ± 0.3 kPa, and with contraction to 2.0 ± 0.7 kPa. Irrespective of muscular state, the erector spinae was significantly stiffer than the multifidus. The multifidus underwent proportionally higher stiffness changes from rest to contraction and stretching. MRE can be used to measure the stiffness of the LPM in different muscular states. We hypothesize that, irrespective of posture, the erector spinae behaves as semi-rigid beam, and ensures permanent stiffness of the spine. The multifidus behaves as an adaptable muscle that provides segmental flexibility to the spine and tunes the spine stiffness. Clin. Anat. 31:514-520, 2018. © 2018 Wiley Periodicals, Inc.
背痛与通过手动触诊和应变弹性成像确定的腰椎旁肌肉（LPM）僵硬增加有关。最近，磁共振弹性成像（MRE）已能够在体内无创地表征肌肉的硬度，提供定量的三维硬度图（弹性图）。本研究的目的是使用MRE表征LPM（多裂肌和竖脊肌）的硬度（剪切模量，SM）。对7名仰卧位的成年人进行了腰椎区域的MRE检查。在三种肌肉状态下采集MRE：双腿伸直放松、被动骨盆屈曲伸展、双腿伸直且躯干肌肉收紧收缩。在多裂肌、竖脊肌和整个椎旁间隙手动定义的感兴趣区域内测量平均SM。通过方差分析和t检验评估肌肉间差异以及伸展和收缩的影响。休息时，椎旁间隙的平均SM为1.6±0.2 kPa。伸展时显著增加至1.65±0.3 kPa，收缩时增加至2.0±0.7 kPa。无论肌肉状态如何，竖脊肌的硬度均显著高于多裂肌。从休息到收缩和伸展，多裂肌的硬度变化比例更高。MRE可用于测量不同肌肉状态下LPM的硬度。我们假设，无论姿势如何，竖脊肌表现为半刚性梁，并确保脊柱的永久硬度。多裂肌表现为适应性肌肉，为脊柱提供节段性灵活性并调节脊柱硬度。《临床解剖学》2018年第31卷：514 - 520页。© 2018威利期刊公司。
