The Clinical Study Of Shear Wave Elastography In Trapezius Myofascial Pain Syndrome

Objective:Application of shear wave elastography(SWE)technology quantitative analysis of trapezius myofascial pain syndrome in patients with trapezius trigger points the shear wave velocity(SWV)value,numeric rating scale was used as the control criterion.To obtain the optimal SWV threshold for patients with different pain groups,it provides new information for the clinical to evaluate different pain degree of patients with trapezius myofascial pain syndrome.Materials and methods:Sixty-eight patients(85 trigger points)with trapezius pain syndrome were selected as the case group,and 51 healthy volunteers(51 normal muscle points)with gender,age and body mass index matching were selected as the control group.The numeric rating scale was used to assess the pain degree of each trigger point area,and according to the score,85 trigger points were divided into mild pain group,moderate pain group and severe pain group.Application of SWE elasticity imaging to observe trigger points,and the characteristics of the gray-scale images,at the same time measurement cases to the seventh cervical spinous process pain side shoulder peak attachment midpoint(trapezius trigger points area)maximum shear wave velocity(SWVmax)value,the average shear wave velocity(SWVmean)value and the minimum shear wave velocity(SWVmin)values.Result:1.The elastic image of trapezius in the control group was uniform blue.The elastic image of the case group is shown in blue or mixed green and blue.The elastic image of the trigger point is an elliptic mixed green and red with clear boundary,and the echo of trigger point in the gray scale image is lower than the trapezius echo.2.SWV values in each case group were greater than those in the control group(P<0.05).The SWV value of the mild,moderate and severe pain group showed a gradually increasing trend.3.Pearson correlation analysis showed that SWVmax,SWVmean and SWVmin in the case group were positively correlated with numeric rating scale score(r=0.929,0.934,0.903;P=0.000).4.The optimal critical value of SWV in the trigger point area of each pain group:①mild pain was SWVmax>4.6m/s,SWVmean>1.79m/s,and SWVmin≤2.04m/s.(the sensitivity was 96.04%and the specificity was 86.71%);②moderate pain was SWVmax>4.35m/s,SWVmean>2.94,and SWVmin>2.04(the sensitivity was 97.4%,and the specificity was 83.82%);③severe pain was SWVmax>7.05m/s,SWVmean>4.16m/s,and SWVmin>2.75m/s(the sensitivity was 100.00%,and the specificity was 100.00%).Conclusion:1.The exact location of the trigger point can be traced using the SWE image,which echoes lower than the trapezius echo in the gray scale image.2.SWVmax,SWVmean and SWVmin values of trapezius trigger points in the case group were positively correlated with the score of numeric rating scale,indicating that SWV values could indirectly reflect the pain degree of patients and had good application value.3.SWVmax,SWVmean and SWVmin were combined to evaluate the trapezius trigger points of different pain degrees,which showed the highest sensitivity and specificity for patients with severe pain.