剪切波弹性成像在脑卒中后下肢痉挛康复效果评估中的应用及外科意义

doi:10.3969/j.issn.2095-378X.2025.02.002

Abstract

Abstract: Objective To explore the application effect of ultrasound shear wave elastography （SWE） in the evaluation of efficiency of lower limb spasticity rehabilitation in stroke patients and its potential correlation with the demand for surgical treatment. Methods Sixty stroke patients with hemiplegia and spasticity in the lower limbs （research group） and 60 healthy volunteers （control group） who were treated at Shanghai Ruijin Rehabiliation Hospital from January 2023 to December 2024 were enrolled in the study. The Young’s modulus （YM） values of gastrocnemius muscle in the control group and the research group before and after rehabilitation treatment were measured by SWE, and the lower limb muscle strength of the research group before and after rehabilitation was evaluated by modified Ashworth scale （MAS）. After treatment, the research group was divided into a predictive operation group （the YM values of the affected side >50% of the healthy side, and secondary intervention was required） and a conservative treatment group （no secondary intervention was required） according to the changes of gastrocnemius muscle YM values before and after treatment to compare the YM values before treatment. Results In the research group, the YM value of the gastrocnemius muscle was significantly decreased after treatment [（63.45±19.92） kPa vs （48.32±19.83） kPa, P<0.05], and the MAS score was significantly improved [（2.35±1.02） vs （1.50±1.23）, P<0.05]. There was a positive correlation between YM and MAS scores （r=0.630, P<0.05）. Subgroup analysis showed that the predictive operation group （22 cases） had a significantly higher YM value than the conservative treatment group [（78.35±14.18） kPa vs（46.19±18.40） kPa, P<0.05]. Conclusion SWE can quantitatively analyze the rehabilitation effect of post-stroke spasticity of lower limbs and predict the demand for treatment （High YM value is potentially associated with the demand for surgical treatment）, which provides objective and powerful evidence for clinical treatment.

Key words: Ultrasound, Shear wave elastography, Young's modulus, Modified Ashworth scale, Gastrocnemius muscle spasticity, Stroke, Surgery

CLC Number:

R445.1

HUANG Li, TANG Xiaofang, MENG Cong, BAO Yong, LIU Jun. Application and surgical significance of shear wave elastography in evaluation of rehabilitation effect of lower limb spasticity after stroke[J]. Surgical Research and New Technique, 2025, 14(2): 107-112.

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Application and surgical significance of shear wave elastography in evaluation of rehabilitation effect of lower limb spasticity after stroke

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