超音波で嚥下時のオトガイ舌骨筋評価

超音波でオトガイ舌骨筋の嚥下時の動きを評価した論文を紹介します。

Yabunaka K, Konishi H, Nakagami G, Sanada H, Iizaka S, Sanada S, Ohue M. Ultrasonographic evaluation of geniohyoid muscle movement during swallowing: a study on healthy adults of various ages. Radiol Phys Technol. 2012 Jan;5(1):34-9.

上図がオトガイ舌骨筋の超音波で、左のMモードの①が嚥下開始時、②が嚥下終了時です。Mモードを使用してオトガイ舌骨筋の収縮距離や収縮時間を計算することができます。これを世代の異なる健常者で評価しました。

結果ですが、描出は全員可能でした。オトガイ舌骨筋の収縮距離や収縮時間は加齢とともに長くなる傾向でしたが、統計学的有意差は認めませんでした。収縮距離と収縮時間は、女性より男性で有意に長かったです。超音波によるオトガイ舌骨筋は嚥下評価に有用な可能性があります。

統計学的有意差はありませんでしたが、オトガイ舌骨筋の収縮距離と収縮時間が加齢とともに長くなるのは、オトガイ舌骨筋のサルコペニアの影響があるかもしれません。超音波でオトガイ舌骨筋の筋肉量や筋肉内脂肪浸潤の程度がわかれば、サルコペニアの嚥下障害の評価により有用だと感じます。

Abstract

Our purpose in this study was to investigate the application of B+M-mode ultrasound (B/M-mode) imaging as a new approach to quantifying activity patterns of the geniohyoid muscles during swallowing and to assess how these patterns differ according to age and gender. Sixty healthy volunteers (30 men, 30 women) were divided into three age groups (20-39, 40-59, 60-79 years). The subjects were then given 10 ml of mineral water. Ultrasonographic imaging was repeated 5 times and measurements were averaged. Simultaneous B/M-mode images were captured at two regions along the lateral geniohyoid muscle wall. All geniohyoid muscle movement was recorded by real-time B/M-mode. In all cases, ultrasonographic images of the geniohyoid muscle movement during swallowing were easily visualized with the use of real-time B/M-mode. The average moving distance and the duration of movement of the geniohyoid muscle during contraction increased gradually with age. There was a significant difference in ultrasonic measurements of the moving distance and the duration of movement during swallowing between males and females in the three age groups (P < 0.05). B/M-mode imaging provides a simple, noninvasive technique for visual assessment of the lateral geniohyoid muscle wall and may provide a clinical method for evaluating swallowing.