Barun Blaž, Barišić Igor, Krnić Ana, Benzon Benjamin, Vlak Tonko, Aljinović Jure
Institute of Physical and Rehabilitation Medicine with Rheumatology, University Hospital Split, Šoltanska 1, 21000 Split, Croatia.
Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia.
Diagnostics (Basel). 2021 Nov 10;11(11):2077. doi: 10.3390/diagnostics11112077.
A prospective observational study comparing shear wave elastography (SWE) of trapezius muscle with Neck Disability Index (NDI) in a prediction model of health status six months after a whiplash injury. Both SWE values, measured by two radiologists, and NDI scores were obtained at baseline and after physical therapy (PT) (6-month period). Those values were compared with a 3-point Likert scale (no, partial or full recovery). Twenty-two subjects completed the study. A decrease in trapezius stiffness was detected by both radiologists, statistically significant for one (Δ10.1 kPa; = 0.04) but not for the second radiologist (Δ8.63 kPa; = 0.07). The measurements showed excellent intra-observer (ICC 0.75-0.94) and inter-observer (ICC 0.78-0.88) reliability. After six months, fully recovered patients showed lower NDI scores than partially recovered patients (Δ22.98; < 0.001). SWE values did not differ with the recovery status (55.6 ± 9.7 vs. 57 ± 15.8, Δ1.45; = 0.82). The single most accurate variable in classifying health status six months after whiplash injury was the relative change of NDI, and it showed the highest accuracy (73.9%) and low Akaike information criterion (AIC = 39.2). Overall, the most accurate classification was obtained when combining NDI and SWE after physical therapy with an accuracy of 77.3% and a decrease in AIC (32.8).
一项前瞻性观察性研究，在挥鞭伤后六个月健康状况的预测模型中，比较斜方肌的剪切波弹性成像（SWE）与颈部功能障碍指数（NDI）。在基线时以及物理治疗（PT）后（6个月期间），获取了由两名放射科医生测量的SWE值和NDI评分。将这些值与3级李克特量表（无、部分或完全恢复）进行比较。22名受试者完成了该研究。两名放射科医生均检测到斜方肌僵硬程度降低，其中一名有统计学意义（Δ10.1 kPa；P = 0.04），而另一名放射科医生检测的结果无统计学意义（Δ8.63 kPa；P = 0.07）。测量结果显示观察者内（组内相关系数ICC 0.75 - 0.94）和观察者间（组内相关系数ICC 0.78 - 0.88）可靠性极佳。六个月后，完全康复的患者NDI评分低于部分康复的患者（Δ22.98；P < 0.001）。SWE值与恢复状态无关（55.6 ± 9.7 vs. 57 ± 15.8，Δ1.45；P = 0.82）。在对挥鞭伤后六个月的健康状况进行分类时，最准确的单一变量是NDI的相对变化，其显示出最高的准确率（73.9%）和较低的赤池信息准则（AIC = 39.2）。总体而言，物理治疗后将NDI和SWE相结合时分类最准确，准确率为77.3%，AIC降低（32.8）。
