Ultrasonic characterization of the upper trapezius muscle in patients with chronic neck pain.
Ultrasonic characterization of the upper trapezius muscle in patients with chronic neck pain.
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DOI：
10.1177/0161734612472408
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发表时间：
2013-04
影响因子：
2.3
通讯作者：
Sikdar S
中科院分区：
文献类型：
--
作者：
Turo D;Otto P;Shah JP;Heimur J;Gebreab T;Zaazhoa M;Armstrong K;Gerber LH;Sikdar S
肌筋膜触发点(MTrp)是骨骼肌紧绷带中可触摸到的压痛结节，受压时疼痛。肌筋膜痛综合征(MPS)的特征性表现是肌筋膜痛综合征。MTrps在MPS的病理生理学中的作用尚不清楚。通过客观地描述和定量测量疼痛MTrP的特性，可以改善其定位、诊断和临床结果。这项研究的目的是评估超声成像和弹性成像是否可以区分症状性(活动性)MTrP和正常肌肉。有自发性疼痛、可触及(即活动的)MTP的慢性(3个月)颈部疼痛的患者和没有自发性疼痛(有明显的正常肌肉组织)的健康志愿者参加了这项研究。对所有受试者的上斜方肌进行成像，并对B超图像进行熵滤波分析回声纹理。通过以100赫兹的频率向外振动肌肉来进行振动弹性成像。采用彩色多普勒方差成像技术对振动幅度较低的色觉缺陷区进行定量。将成像方法与标准化体检的临床结果进行比较。我们发现，在振动弹性成像中，与正常的、未受累的肌肉(n=15)相比，具有活跃的MTrp的部位(n=14)具有显著较低的熵(p<；0.05)和显著较大的非振动区域(p<；0.05)。结合熵分析和振动弹性成像，可以获得69%的灵敏度和81%的特异度来区分活动的MTrP和正常肌肉。这些结果表明，与正常的、未受影响的肌肉相比，活动的MTrP具有更均匀的质地和不同的硬度。我们的方法使我们能够提高可疑MTrp与周围肌肉之间的成像对比度。我们的结果表明，在慢性颈痛和活动期MTrp的受试者中，异常并不局限于离散的孤立结节，而是影响可触及MTrp周围的肌肉环境。随着超声成像技术的进一步完善，超声成像可以作为一种很有前景的客观方法来表征与MTP相关的软组织异常，并阐明MTP在MPS的病理生理学中的作用。
Myofascial trigger points (MTrPs) are palpable, tender nodules in taut bands of skeletal muscle that are painful on compression. MTrPs are characteristic findings in myofascial pain syndrome (MPS). The role of MTrPs in the pathophysiology of MPS is unknown. Localization, diagnosis, and clinical outcome measures of painful MTrPs can be improved by objectively characterizing and quantitatively measuring their properties. The goal of this study was to evaluate whether ultrasound imaging and elastography can differentiate symptomatic (active) MTrPs from normal muscle. Patients with chronic (>3 months) neck pain with spontaneously painful, palpable (i.e., active) MTrPs and healthy volunteers without spontaneous pain (having palpably normal muscle tissue) were recruited for this study. The upper trapezius muscles in all subjects were imaged, and the echotexture was analyzed using entropy filtering of B-mode images. Vibration elastography was performed by vibrating the muscle externally at 100 Hz. Color Doppler variance imaging was used to quantify the regions of color deficit exhibiting low vibration amplitude. The imaging measures were compared against the clinical findings of a standardized physical exam. We found that sites with active MTrPs (n = 14) have significantly lower entropy (p < 0.05) and significantly larger nonvibrating regions (p < 0.05) during vibration elastography compared with normal, uninvolved muscle (n = 15). A combination of both entropy analysis and vibration elastography yielded 69% sensitivity and 81% specificity in discriminating active MTrPs from normal muscle. These results suggest that active MTrPs have more homogeneous texture and heterogeneous stiffness when compared with normal, unaffected muscle. Our methods enabled us to improve the imaging contrast between suspected MTrPs and surrounding muscle. Our results indicate that in subjects with chronic neck pain and active MTrPs, the abnormalities are not confined to discrete isolated nodules but instead affect the milieu of the muscle surrounding palpable MTrPs. With further refinement, ultrasound imaging can be a promising objective method for characterizing soft tissue abnormalities associated with active MTrPs and elucidating the role of MTrPs in the pathophysiology of MPS.
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影响因子：
5
作者：
Khoury, Viviane;Cardinal, Etienne;Brassard, Paul
通讯作者：
Brassard, Paul
影响因子：
7.4
作者：
FISHBAIN, DA;GOLDBERG, M;ROSOMOFF, H
通讯作者：
ROSOMOFF, H
影响因子：
37.8
作者：
SKORTON, DJ;COLLINS, SM;KERBER, RE
通讯作者：
KERBER, RE
影响因子：
37.8
作者：
SKORTON, DJ;COLLINS, SM;MELTON, HE
通讯作者：
MELTON, HE
影响因子：
4.3
作者：
Sikdar, Siddhartha;Shah, Jay P.;Gebreab, Tadesse;Yen, Ru-Huey;Gilliams, Elizabeth;Danoff, Jerome;Gerber, Lynn H.
通讯作者：
Gerber, Lynn H.