剪切波弹性成像技术在评价A型肉毒毒素注射咬肌中的应用

发布时间：2018-03-23 12:54

本文选题：肉毒毒素类　切入点：咬肌　出处：《中国临床医学影像杂志》2017年05期

【摘要】：目的:应用剪切波弹性成像技术(SWE)评估A型肉毒毒素注射咬肌瘦脸的治疗效果。方法 :20例咬肌肥大患者,共40侧咬肌,接受A型肉毒毒素注射前后分别行二维超声及剪切波弹性成像检查,常规超声测量松弛状态和收缩状态下咬肌的厚度,SWE于两种状态下评估咬肌硬度,通过随访记录注射前、注射后1周、1月、3月、6月的各项指标,评价SWE在A型肉毒毒素注射咬肌中治疗效果评估的价值。结果:A型肉毒毒素注射后1周开始,无论是松弛状态还是收缩状态下咬肌厚度均减小,硬度减低,3月随访测量变化最明显,咬肌厚度明显缩小,松弛状态下平均缩小约22.2%±4.2%,收缩状态下平均缩小约22.8%±5.3%,肌硬度也明显下降,松弛状态下杨氏模量值平均缩小约19.5%±3.4%,收缩状态下平均缩小约60.4%±5.8%,6月时厚度及硬度开始恢复。结论:SWE用于动态观察咬肌的肌张力,结合其厚度变化,定量评价A型肉毒毒素注射瘦脸的药物疗效,为二次注射提供最佳的时间与剂量参考。
[Abstract]:Objective: to evaluate the therapeutic effect of botulinum toxin A injection of masseter muscle on skinny face by using shear wave elastic imaging (SWE). Methods: twenty cases of masseter muscle hypertrophy, 40 sides masseter muscle, were used in 20 cases of masseter muscle hypertrophy. Two dimensional ultrasound and shear wave elastic imaging were performed before and after botulinum toxin A injection. The thickness of masseter muscle in relaxation state and contraction state was measured by conventional ultrasound and SWE was used to evaluate the hardness of masseter muscle. One week, one month, three months and six months after injection, the value of SWE in evaluating the therapeutic effect of botulinum toxin A in masseter muscle was evaluated. The thickness and hardness of masseter decreased in both relaxed and contractile states. The change of masseter muscle thickness was the most obvious in 3 months follow-up, and the thickness of masseter muscle decreased obviously. The average shrinkage was about 22.2% 卤4.2% under relaxation and 22.8% 卤5.3 in contractile state, and the hardness of muscle also decreased obviously. The average value of Young's modulus was reduced by 19.5% 卤3.4% under relaxation and 60.4% 卤5.8% by contraction. The thickness and hardness of masseter muscle began to recover at 6 months after relaxation. Conclusion: SWE is used to dynamically observe the muscle tension of masseter muscle and to combine the thickness change of masseter muscle. To evaluate quantitatively the therapeutic effect of Botulinum toxin A injection on thin face, and to provide the best time and dose reference for the second injection.
【作者单位】：复旦大学附属华东医院;
【基金】：上海市卫生局青年科研项目(No.20124y150)
【分类号】：R445.1;R685.3

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