Aysun GENÇ, Uğur KUŞ, Ali AĞUŞ, Sehim KUTLAY, Yeşim KURTAİŞ AYTÜR, Hacı Musab KIYMAZ, Onur BOZDAĞ

Fibromiyalji Sendromunda Hassas Noktaların Ultrason Makaslama Elastografi Hızları ile Klinik Bulgular ve Yaşam Kalitesi Arasındaki İlişki

Amaç: Çalışmanın birincil amacı, Fibromiyalji Sendromu tanısında hassas noktalardaki potansiyel doku değişikliklerinin ve ultrason elastografi akımhızlarının belirlenerek objektif bir veri elde edilmesi, ikincil amaç ise bu akım hızlarının hastalık belirtileri ve yaşam kalitesi ile olan ilişkisini ortayakoyarak bu verilerin hastaların fonksiyonel durumlarının ve tedavilerinin takibinde kullanılabilirliğini sorgulamak.Gereç ve Yöntem: Fibromiyalji Sendromu tanısı ile izlenen, trapezius kasının üst kenarı ve supraspinatus bölgelerinde hassas noktası olan 24 kadınhasta, sabah tutukluğu, uyku kalitesi, ağrı düzeyi (görsel analog skala), ruhsal durum (Beck Depresyon Ölçeği), fonksiyonel durum (Fibromiyalji EtkiSorgulaması) ve yaşam kalitesi (SF-36) ile sorgulandı. Hassas olan üst trapez ve supraspinatus noktalarında ultrason elastografi akım hızları AcusonS2000 ultrason sistemi (Siemens Medical Solutions, Mountain View, CA) ile ölçüldü. Tüm veriler korelasyon açısından istatiksel analize tabi tutuldu.Bulgular: Ortalama yaş 51,4 yıl (min-maks=26-74) olarak saptandı. Sağ trapezius nötral pozisyon ultrason elastografi akım hızları ve bazı SF-36 altskorları arasında ve sol trapez nötral pozisyon ultrason elastografi akım hızları ile Görsel Analog Skoru (r=0,510, p=0,013) arasında pozitif korelasyonsaptandı.Sonuç: Bu veriler Fibromiyalji Sendromunda ultrason elastografi akım hızlarının kantitatif bir tanı kriteri olarak kullanılabilmesi için yeterli değildir.Daha fazla hasta sayısı ve kontrol grubu içeren ileri çalışmalar ile kısmen de olsa saptadığımız anlamlı korelasyonların gösterilmesi gerekir.

The Relationship Between the Tender Point Ultrasound Shear Wave Elastography Velocities and the Symptoms and Quality of Life in Fibromyalgia Syndrome

Objectives: The primary objective of the study was to determine the potential tissue changes and ultrasound elastography flow rates at the sensitive points in patients with fibromyalgia syndrome and to obtain objective data; secondary aim is to determine the relationship between these flow rates and disease symptoms and quality of life and to determine the usefulness of these data in the follow-up of functional status and treatment of patients. Materials and Methods: Twenty-four female patients diagnosed as fibromyalgia syndrome with sensitive points in the upper trapezius and supraspinatus regions were questioned for morning stiffness, sleep quality, pain level (visual analog scale), mental status (Beck Depression Scale), functional status (Fibromyalgia Impact Questionnaire) and quality of life (SF-36). The ultrasound elastography flow velocities at the sensitive upper trapezoidal and supraspinatus points were measured with the Acuson S2000 ultrasound system (Siemens Medical Solutions, Mountain View, CA). All data were analysed statistically for correlation. Results: The mean age was 51.4 years (min-max=26-74). There was a positive correlation between ultrasound elastography flow rates and some SF-36 subscores and left trapezoidal neutral position and Visual Analogue Score (r=0.510, p=0.013). Conclusion: The data is not sufficient to use ultrasound elastography flow rates as a quantitative diagnostic criterion in fibromyalgia syndrome. Further studies involving enough sample size and including a control group will allow the questioning of the true value of the significant correlations that we find.

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