The Study Of Shear Wave Elastography In Evaluating The Skeletal Muscle Hardness Before And After The Injection Of Botulinum Toxin A In Treating Extremities Spasm In Patients With The Central Nervous System Diseases

ObjectiveTo investigate the value of the Shear Wave Elastography (SWE) Technique in evaluating the skeletal muscle hardness before and after the injection of Botulinum Toxin A(BTXA) in treating extremities spasm, and to evaluate the value of the new quantitative modality in assessing the clinical therapeutic effect in patients with the central nervous system diseases.MethodsSWE measurements were conducted on 170 spasm muscles and their contralateral counterparts in 33 patients with central nervous system diseases. Clinical rehabilitative evaluations were also performed. Data were reassessed in four weeks after the treatment of BTXA.Results1. Before the treatment of BTXA, in a resting position, the Young’s modulus value of the affected side were larger than that of the contralateral side with no significant difference(P＞0.05). In a stretching position, the Young’s modulus value of the affected side were larger than that of the contralateral side with significant difference (P＜0.05).2. In comparison with the measurement before treatment, the Young’s modulus value of muscles in the affected side were smaller after the treatment with significant difference (P＜0.05).3. After the treatment of BTXA, in a resting position, the Young’s modulus value of the affected side were smaller than that of the contralateral side with no significant difference (P＞0.05). In a stretching position, the Young’s modulus value of the affected side were larger than that of the contralateral side with no significant difference (P>0.05).4. The Young’s modulus of the skeletal muscles in a stretching position were larger than that in a resting position before the treatment of BTXA in the affected side as well as in the contralateral side, both of which had significant difference(P＜0.05). The Young’s modulus of the skeletal muscles in a stretching position were larger than that in a resting position after the treatment of BTXA in the affected side as well as in the contralateral side, both of which had significant difference (P＜0.05).5. Significant difference was observed in the scores of the MAS before and after the treatment. However, there was no significant difference in the FMA scores before and after the treatment, so as in the scores of Bathel Index.Gonelusion1. It’s applicable to measure the elastic modulus of skeletal muscles by SWE.2. The Young’s modulus of the skeletal muscles decreased after the injection of BTXA in a stretching position as well as in a resting position.3. The treatment with BTXA can relieve muscular spasm and decrease the muscular tension measured by MAS.4. The Young’s modulus of the skeletal muscles in a stretching position were larger than that in a resting position in the affected side as well as the contralateral side.