Diagnostic Value Of Two-dimensional Ultrasound Combined With Shear Wave Elastography In Female Ultrasonic Workers With Chronic Low Back Pain

Objective: Two-dimensional ultrasound combined with shear wave elastography(SWE)was used to evaluate the characteristics of changes in the morphology and elasticity of erector spinae(ES)in female sonographers,analyze the related influencing factors,and investigate the diagnostic value of shear wave elastography in chronic low back pain(CLBP)in sonographers.Methods: One hundred and eight female ultrasound workers from seven hospitals in Handan were selected as the observation group and divided into three groups according to their working years: Group A1:(<10years)35,25-34 years old;Group A2:(10-20 years)36,34-41 years old;Group A3:(>20 years)37,43-56 years old.During the same period,101 healthy female volunteers without sedentary behaviour were screened as the control group,and the age groups were matched with the observation group and divided into 3 groups: Group B1: 33,26-33 years old;Group B2:37,35-38 years old;Group B3: 31,45-54 years old.The visual analogue scale(VAS)and the Oswestry Disability Index(ODI)were used to score the sensation and function of low back pain in the study subjects.Two-dimensional ultrasound combined with SWE was used to examine the erector spinae muscles and to measure the cross-sectional area,thickness and shear wave velocity(SWV),store the images and record the data.The differences in age,weight,height and BMI between the observation and control groups were compared;Compare and analyze the differences between the observation group and the control group in the cross-sectional area,thickness and SWV of the erector spine muscle;Compare and analyze the difference of SWV value between the left and right sides of the erector spinal muscles in the observation group.Statistical analysis was performed by applying statistical methods consistent with the type of data,and differences were considered statistically significant at P < 0.05.Results:1.In the two-dimensional sonogram comparison,the texture of the erector spinae muscle bundle was disorganized,poorly continuous and unevenly spaced in the observation group compared to the control group;the fascia was thickened and the echogenicity was enhanced.2.When comparing the ultrasound parameters,the SWV values of the erector spinae in the observation group were higher than those in the control group,and the SWV values of the right erector spinae in the observation group were higher than those of the left,with statistically significant differences(P < 0.05);the values of the cross-sectional area and thickness of the erector spinae in the observation group were smaller than those in the control group(P < 0.05).Conclusion:1.Morphological changes in the erector spinae muscle in ultrasound workers who have been working for more than 20 years.2.Two-dimensional ultrasound can diagnose the morphological changes of muscle tissue,but it lacks sensitivity in the early stage of the disease.3.The rigidity of the vertical spine muscles of female ultrasonic workers increases with the increase of working years,and the rigidity of the vertical spine muscles on the right side is greater than that on the left side during the same working years.4.SWE technology can dynamically,objectively and quantitatively evaluate the physiological and pathological state of muscle tissue.The elastic changes of muscle tissue are earlier than the changes of two-dimensional ultrasound morphology.SWE technology is more sensitive in evaluating the changes of muscle tissue,which makes up for the shortcomings of two-dimensional ultrasound to a certain extent,and has a significant application prospect.