Ultrasonographic Findings in Hemiplegic Shoulders of Stroke Patients

半身癱瘓患者患側肩部之超音波影像特徵

10.6452/KJMS.200202.0070

李佳玲(Chia-Ling Lee)；陳天文(Tien-Wen Chen)；翁銘正(Ming-Cheng Weng)；王郁苓(Yu-Lin Wang)；鄭旭昇(Hsu-Sheng Cheng)；黃茂雄(Mao-Hsiung Huang)

Ultrasonography ； hemiplegia ； shoulder

The Kaohsiung Journal of Medical Sciences

18卷2期（2002 / 02 / 01）

70 - 76

英文

半身癱瘓的病人常見有肩部的問題，這樣的問題常會阻礙復健的進行，過去使用許多工具來評估肩部的問題，然而那些工具不是對軟組織沒有好的顯像力，就是有不便或太昂貴的缺點。本篇研究主要是使用超音波來評估半身癱瘓病人肩部軟組織及關節的變化。82位半身癱瘓的病人接受評估，使用的是ATL 5-12MHz變頻高解析度的探頭，以非癱瘓側的肩膀做為對照組。結果發現超音波上的變化的在癱瘓側有51個（62.2%）而在非癱瘓側只有17個（20.7%），兩者間有顯著的意義。其中積水（effusion）和肌腱炎（tendinitis）是最多的發現，與非癱瘓側比較有統計學上的差異，棘上肌破裂在癱瘓側也有較高的發生率但無統計學上顯著意義。進一步的分析指出，罹病時間長短和癱瘓側肩關節的超音波異常表徵的發生率沒有顯著相關。因此，我們提出超音波可以是評估半身癱瘓患者肩部問題的一個良好的工具。

Shoulder problems are frequently noted in hemiplegic shoulders and compromise rehabilitation. Many tools were used to evaluate the etiology of shoulder problems but most of them are either nonspecific to the evaluation of soft tissue or not convenient. In order to evaluate soft tissue and joint change in hemiplegic shoulders, 82 patients with hemiplegic shoulders caused by cerebral vascular accident (CVA( were collected and evaluated by ultrasonography with 5-12 MHz high-resolution electronic linear scanner (ATL ultrasound HDI 1500, USA). The non-hemiplegic shoulders were also studied as control group. The results showed that ultrasonographic changes were noted in 51 (62.2%) hemiplegic shoulders while changes only occurred in 17 (20.7%) non-hemiplegic shoulders. Effusion and tendonitis were the major changes showing statistical difference compared with non-hemiplegic shoulders, but there was no significant difference in the incidence of supraspinatus tendon tear between hemiplegic and non-hemiplegic shoulders. Further, the interval from the onset of CVA was not significantly correlated with the presence of positive ultrasonographic findings in hemiplegic shoulders. The results demonstrated that ultrasonography is a potential method in the evaluation of hemiplegic shoulder.