Novel applications of ultrasound technology to visualize and characterize myofascial trigger points and surrounding soft tissue.
Novel applications of ultrasound technology to visualize and characterize myofascial trigger points and surrounding soft tissue.
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DOI：
10.1016/j.apmr.2009.04.015
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发表时间：
2009-11
影响因子：
4.3
通讯作者：
Gerber, Lynn H.
中科院分区：
文献类型：
--
作者：
Sikdar, Siddhartha;Shah, Jay P.;Gebreab, Tadesse;Yen, Ru-Huey;Gilliams, Elizabeth;Danoff, Jerome;Gerber, Lynn H.
关键词：
应用超声（US）成像技术更好地描述肌筋膜触发点（MTrP）和紧邻软组织的特征。描述性（探索性）研究。生物医学研究中心。9例受试者符合Travell和Simons关于上腹肌绷紧带中MTrPs的标准。（无）通过1）体格检查，2）压力痛觉测量和3）三种类型的超声成像（包括灰度（2D US）、振动声弹性成像（VSE）和多普勒）评价MTrP。根据体格检查，将每例患者的4个部位标记为活动性MTrP（自发性疼痛，A-MTrP）、潜伏性MTrP（无痛性，L-MTrP）或正常肌筋膜组织。由对体格检查结果不知情的团队对每例受试者进行US检查。使用12-5 MHz超声换能器。通过彩色多普勒方差成像进行VSE，同时用手持式按摩振动器诱导振动（~ 92 Hz）。每个部位的组织成像评分（TIS）如下：0 =均匀回声和硬度; 1 =局灶性低回声区域伴硬结节; 2 =多个低回声区域伴硬结节。使用多普勒成像评估MTrPs附近的血流。每个部位的血流波形评分（BFS）如下：0 =肌肉中动脉血流正常; 1 =舒张期血流升高; 2 =高阻力血流波形伴舒张期血流逆行。MTrPs在2D US上表现为局灶性低回声区域，表明组织回声的局部变化，在VSE上表现为振幅降低的局灶性区域，表明局部僵硬结节。MTrP呈椭圆形，大小为0.16 ± 0.11 cm 2。A-MTrPs和L-MTrPs之间的大小没有显著差异。与正常肌筋膜组织相比，含有MTRP的部位更可能具有更高的TIS（p<0.002）。A-MTrPs附近的小动脉（或扩大的小动脉）显示在微血管中逆行流动，表明高阻力血管床。与L-MTrP相比，A-MTrP位点更可能具有更高的BFS（p<0.021）。初步结果表明，在本研究的条件下，US成像技术可用于区分含有MTrPs的肌筋膜组织与正常肌筋膜组织（缺乏触发点）。超声能够实现MTrP和邻近软组织的可视化和一些表征。
Apply ultrasound (US) imaging techniques to better describe the characteristics of myofascial trigger points (MTrPs) and the immediately adjacent soft tissue. Descriptive (exploratory) study. Biomedical research center. 9 subjects meeting Travell and Simons’s criteria for MTrPs in a taut band in the upper trapezius. (None) MTrPs were evaluated by 1) physical examination, 2) pressure algometry, and 3) three types of ultrasound imaging including grayscale (2D US), vibration sonoelastography (VSE), and Doppler. Four sites in each patient were labeled based on physical examination as either active MTrP (spontaneously-painful, A-MTrP), latent MTrP (non-painful, L-MTrP), or normal myofascial tissue. US examination was performed on each subject by a team blinded to the physical findings. A 12-5 MHz US transducer was used. VSE was performed by color Doppler variance imaging while simultaneously inducing vibrations (~92Hz) with a handheld massage vibrator. Each site was assigned a tissue imaging score (TIS) as follows: 0 = uniform echogenicity and stiffness; 1 = focal hypoechoic region with stiff nodule; 2 = multiple hypoechoic regions with stiff nodules. Blood flow in the neighborhood of MTrPs was assessed using Doppler imaging. Each site was assigned a blood flow waveform score (BFS) as follows: 0 = normal arterial flow in muscle; 1 = elevated diastolic flow; 2 = high-resistance flow waveform with retrograde diastolic flow. MTrPs appeared as focal, hypoechoic regions on 2D US, indicating local changes in tissue echogenicity, and as focal regions of reduced vibration amplitude on VSE, indicating a localized stiff nodule. MTrPs were elliptical in shape, with a size of 0.16 ± 0.11 cm2. There were no significant differences in size between A-MTrPs and L-MTrPs. Sites containing MTrPs were more likely to have higher TIS compared to normal myofascial tissue (p<0.002). Small arteries (or enlarged arterioles) near A-MTrPs showed retrograde flow in diastole indicating a highly resistive vascular bed. A-MTrP sites were more likely to have higher BFS compared to L-MTrPs (p<0.021). Preliminary findings show that, under the conditions of this investigation, US imaging techniques can be used to distinguish myofascial tissue containing MTrPs from normal myofascial tissue (lacking trigger points). Ultrasound enables visualization and some characterization of MTrPs and adjacent soft tissue.
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影响因子：
2.4
作者：
GAO, L;PARKER, KJ;LERNER, RM
通讯作者：
LERNER, RM
影响因子：
5.1
作者：
Calandre, EP;Hidalgo, J;Rico-Villademoros, F
通讯作者：
Rico-Villademoros, F
影响因子：
2.4
作者：
Gennisson, JL;Cornu, C;Portero, P
通讯作者：
Portero, P
影响因子：
4.2
作者：
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通讯作者：
Kim, Yongmin
影响因子：
3.7
作者：
Fernandez-de-Las-Penas, Cesar;Simons, David;Pareja, Juan
通讯作者：
Pareja, Juan