| Objective:This study used high-frequency ultrasound combined with shear wave elastography(SWE)to determine the changes in ultrasonic signs,shear wave velocity,Young’s modulus and visual analogue scale(VAS)score of inferior oblique muscle superficial fascia,inferior oblique muscle and semispinalis capitis muscle in patients with cervicogenic headache(CEH),which were compared before and after ultrasound-guided interventional therapy to explore the value in interventional therapy.Methods: From September 2020 to October 2021,30 patients with CEH who were treated in the Department of Neurology and Orthopedics of the Affiliated Hospital of Inner Mongolia Medical University and accorded with the inclusion criteria were selcted.Before enrollment,VAS score,inferior oblique muscle superficial fascia,inferior oblique muscle and semispinalis capitis muscle were examined by high-frequency ultrasound and shear wave elastography,and the spasticity of inferior oblique muscle and semispinalis capitis muscle within 1 minute was observed and recorded.After enrollment,ultrasound-guided interventional therapy was performed regularly,and the VAS score was re-measured in 30 minutes after treatment,and the above indicators were re-examined in 1 month,3 months,and 6 months after treatment.The changes of ultrasound indexes and VAS scores were compared before and after treatment,as well as the analysis of their correlation,to quantitatively evaluate the efficacy of ultrasound-guided interventional therapy in patients with CEH.Results:1.The thickness of the superficial fascia of inferior oblique muscle decreased at 1 month,3 months and 6 months after treatment compared with before treatment,and the difference was statistically significant(P<0.05).The thickness of the superficial fascia of inferior oblique muscle decreased at 3 months after treatment compared with1 month after treatment,and the difference was statistically significant(P<0.05).There was no significant difference in the thickness of the superficial fascia of the inferior oblique muscle at 6 months after treatment compared with 1 month and 3months after treatment(P>0.05).2.The thickness of the semispinalis capitis muscle increased at 6 months and 3 months after treatment,and the difference was statistically significant(P<0.05).There was no significant difference in the thickness of semispinalis capitis muscle in 1month after treatment compared with before treatment,3 months and 6 months after treatment compared with 1 month after treatment,and 6 months after treatment compared with 3 months after treatment(P>0.05).The thickness of the inferior oblique muscle at 6 months and 1 month after treatment and the difference was statistically significant(P<0.05).There was no significant difference in the thickness of the inferior oblique muscle in 3 months after treatment compared with before treatment and 1 month after treatment,and 6 months after treatment compared with 1month and 3 months after treatment(P>0.05).3.The number of the spasm frequency of semispinalis capitis muscle decreased at 1 month,3 months and 6 months after treatment compared with before treatment,and the differences were statistically significant(P<0.05).There was no significant difference in the number of the spasm frequency of semispinalis capitis in 3 months and 6 months after treatment compared with 1 month after treatment,and 6 months after treatment compared with 3 months after treatment(P>0.05).The number of spasms of inferior oblique muscle decreased at 3 and 6 months after treatment compared with before treatment,and the difference was statistically significant(P<0.05).There was no significant difference in the number of spasms of inferior oblique muscle in 1 month after treatment compared with before treatment,3 months and 6 months after treatment compared with 1 month after treatment,and 6 months after treatment compared with 3 months after treatment(P>0.05).4.The maximum Young’s modulus(Emax),the mean Young’s modulus(Emean),the maximum shear wave velocity(SWVmax)and the mean shear wave velocity(SWVmean)of the semispinalis capitis muscle were measured at 1 month,3 months and 6 months were lower than those before treatment,and the difference was statistically significant(P<0.05).The semispinalis capitis muscle Emax,Emean,SWVmax and SWVmean at 3 months and 6 months after treatment were lower than those at 1 month after treatment,and the difference was statistically significant(P<0.05).There was no significant difference in the Emax,Emean,SWVmax and SWVmean of the semispinalis capitis muscle were measured between 3 months after treatment and 6 months after treatment(P>0.05).5.The VAS score at 30 minutes after the first,second,and third treatment and at 1 month,3 months,and 6 months after treatment was lower than that before treatment,and the differences were statistically significant(P<0.05).There was no significant difference in the VAS score in 3 months and 6 months after treatment compared with1 month after treatment,and 6 months after treatment compared with 3 months after treatment(P>0.05).6.The 30-minute effective rate after the first,second and third treatment were100%;the effective rate was 91.18% in 1 month after treatment,88.28% in 3 months after treatment,and 88.24% in 6 months after treatment.7.Correlation analysis showed that the decrease of Emean,Emax and SWVmax before and after treatment was positively correlated with the decrease of VAS score before and after treatment(P<0.05).There was no significant correlation between the changes of the superficial fascia of the inferior oblique muscle,the muscle thickness of the inferior oblique muscle and the semispinalis capitis,and the SWVmean before and after treatment(P>0.05).Conclusion: High-frequency ultrasound can clearly display and measure the ultrasound indexes and anatomical relationship of the posterior deep fascia and posterior neck muscles.SWE can non-invasively and quantitatively evaluate the stiffness of the lesioned muscles in patients with CEH in real time.The combination of the two can evaluate the ultrasound guidance clearly.Preliminary studies suggest that ultrasound-guided interventional therapy is a safe and effective invasive method for the treatment of CEH,providing an objective theoretical basis for clinicians to formulate reasonable treatment plans in the diagnosis and treatment of CEH and to monitor the changes of the condition synchronously. |
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