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肌肉超声在肌病中的应用。

Muscle ultrasound in myopathies.

机构信息

Nerve-Muscle Unit, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Department of Neurology, University Hospital of Patras, Patras, Greece.

出版信息

Curr Opin Neurol. 2024 Oct 1;37(5):549-557. doi: 10.1097/WCO.0000000000001306. Epub 2024 Jul 25.

Abstract

PURPOSE OF REVIEW

This review highlights recent developments in the field of muscle ultrasound (MUS) for the diagnosis and follow up of muscle disorders.

RECENT FINDINGS

The diagnostic screening capacity of quantitative grayscale analysis is still sufficient to assess children suspected of a neuromuscular disorder. A combination of visual and quantitative assessment is advised for optimal interpretation. MUS was more sensitive but less specific than MRI for detecting pathology in limb girdle dystrophies and inflammatory myopathies. New techniques such as shearwave elastography and artificial intelligence algorithms for automated image segmentation show promise but need further development for use in everyday practice.Muscle ultrasound has high correlations with clinical measures of function in skeletal and respiratory muscles and the orofacial region, in most of the myopathies and dystrophies studied. Over time, imaging changes precede changes in clinical status, making them attractive for biomarker use in trials. In Duchenne muscular dystrophy MUS was also responsive to the effects of steroid treatment.

SUMMARY

Muscle ultrasound is a sensitive technique to diagnose and follow up of skeletal, facial and respiratory muscles in neuromuscular disorders. Its role is both complementary to and partially overlapping with that of MRI.

摘要

目的综述

本文重点介绍肌肉超声(MUS)在肌肉疾病的诊断和随访方面的最新进展。

最近的发现

定量灰阶分析的诊断筛查能力仍然足以评估疑似神经肌肉疾病的儿童。建议进行视觉和定量评估相结合,以进行最佳解读。与 MRI 相比,MUS 对检测肩带肌营养不良症和炎性肌病的病理学更敏感,但特异性更低。剪切波弹性成像等新技术和用于自动图像分割的人工智能算法具有很大的应用前景,但仍需要进一步开发,以便在日常实践中使用。

在大多数研究的肌肉疾病和营养不良中,肌肉超声与骨骼和呼吸肌以及口面区域的临床功能测量具有高度相关性。随着时间的推移,成像变化先于临床状态的变化,使其成为试验中生物标志物的有吸引力的选择。在杜氏肌营养不良症中,MUS 也对类固醇治疗的效果有反应。

总结

肌肉超声是一种敏感的技术,可用于诊断和随访神经肌肉疾病中的骨骼、面部和呼吸肌。它的作用与 MRI 互补且部分重叠。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c129/11377056/6943fd9a6498/coneu-37-549-g001.jpg

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