| 张琪瑶,乔春梅,王欣,王晓磊.高频超声联合剪切波弹性成像用于评估重复性枕大神经阻滞治疗颈源性头痛效果[J].中国医学影像技术,2023,39(11):1605~1609 |
| 高频超声联合剪切波弹性成像用于评估重复性枕大神经阻滞治疗颈源性头痛效果 |
| High frequency ultrasound combined with shear wave elastography for assessing effectiveness of repetitive greater occipital nerve blocks in treatment of cervicogenic headache |
| 投稿时间：2023-03-13 修订日期：2023-10-08 |
| DOI：10.13929/j.issn.1003-3289.2023.11.002 |
| 中文关键词: 头痛 介入治疗 超声检查 前瞻性研究 |
| 英文关键词:headache interventional therapy ultrasonography prospective studies |
| 基金项目:内蒙古自治区自然科学基金项目(2019MS08027)。 |
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| 中文摘要: |
| 目的 探讨高频超声联合剪切波弹性成像(SWE)评估重复性枕大神经阻滞治疗颈源性头痛(CEH)效果的价值。方法 前瞻性纳入30例CEH患者行超声引导下重复性枕大神经阻滞。分别于治疗前、后以视觉模拟评分法(VAS)判断头痛程度;采用高频超声及SWE测量头半棘肌、头下斜肌及头下斜肌浅方深筋膜相关参数,对比治疗前、后各指标变化情况及其与VAS评分的相关性。结果 相比治疗前,介入治疗后1个月,头下斜肌厚度增加,而头下斜肌浅方深筋膜厚度、头半棘肌痉挛频率、头半棘肌最大及平均剪切波速度(SWVmax、SWVmean)均降低(P均＜0.05)。治疗后3个月,相比治疗前,头半棘肌厚度增加,而头下斜肌浅方深筋膜厚度、头半棘肌及头下斜肌痉挛频率、头半棘肌SWVmax及SWVmean均降低(P均＜0.05);且相比治疗后1个月,头下斜肌浅方深筋膜厚度、头半棘肌SWVmax及SWVmean减低(P均＜0.05)。治疗后6个月,相比治疗前,头半棘肌、头下斜肌厚度增加,而头下斜肌浅方深筋膜厚度、头半棘肌及头下斜肌痉挛频率、头半棘肌SWVmax及SWVmean降低(P均＜0.05);相比治疗后1个月,头半棘肌SWVmax及SWVmean减低(P均＜0.05)。治疗后各时间点CEH患者VAS评分均较治疗前降低(P均＜0.05);治疗后6个月头半棘肌SWVmax降低幅度与VAS降低幅度呈正相关(r=0.365,P＜0.05)。结论 高频超声联合SWE可用于评估重复性枕大神经阻滞治疗CEH效果。 |
| 英文摘要: |
| Objective To explore the value of high frequency ultrasound combined with shear wave elastography (SWE) for assessing effectiveness of repetitive greater occipital nerve blocks in treatment of cervicogenic headache (CEH). Methods Thirty patients of CEH were prospectively enrolled, and repetitive greater occipital nerve blocks were performed under ultrasound guidance. Visual analogue scale (VAS) was used to assess the degree of headache before and after treatment. High frequency ultrasound and SWE were used to measure parameters related to the semispinalis, obliquus capitis inferior, and superficial deep fascia of obliquus capitis inferior. The changes of various indicators before and after treatment and their correlations with those of VAS were analyzed. Results Compared with before treatment, the thickness of obliquus capitis inferior increased, while the thickness of superficial deep fascia of obliquus capitis inferior, frequency of spasms of semispinalis inferior, and the maximum and mean shear wave velocities (SWVmax, SWVmean) of semispinalis muscle decreased at 1 month after interventional treatment (all P＜0.05). Three months after treatment, the thickness of semispinalis muscle increased, and the thickness of superficial deep fascia of obliquus capitis inferior, frequency of spasms of semispinalis and obliquus capitis inferior, as well as SWVmax, SWVmean of semispinalis muscle decreased compared with those before treatment (all P＜0.05), while the thickness of superficial deep fascia of obliquus capitis inferior, and SWVmax and SWVmean of semispinalis muscle decreased compared with those at 1 month after treatment (all P＜0.05). Six months after treatment, the thickness of semispinalis muscle and obliquus capitis inferior increased, the thickness of superficial deep fascia of obliquus capitis inferior, frequency of spasms of semispinalis and obliquus capitis inferior, as well as SWVmax and SWVmean of semispinalis muscle decreased compared with those before treatment (all P＜0.05), while SWVmax and SWVmean of semispinalis muscle decreased compared with those 1 month after treatment (both P＜0.05). After treatment, VAS decreased at all time points compared with before treatment (all P＜0.05). The decrease of SWVmax of head semispinalis muscle 6 months after treatment was positively correlated with the that of VAS in CEH patients (r=0.365, P＜0.05). Conclusion High frequency ultrasound combined with SWE could be used to evaluate the efficacy of repetitive greater occipital nerve blocks for treating CEH. |
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