RESEARCH WORK
Accepted: 2025-08-09
Objective To investigate the impact of magnetic resonance imaging (MRI) combined with musculoskeletal ultrasound on the assessment and correlation of musculoskeletal function adjacent to the dorsal root ganglion (DRG) in patients with zoster-associated pain (ZAP). Methods Included patients with ZAP from June 2020 to July 2023 in our hospital, divided into postherpetic neuralgia group (n=45) and herpes zoster neuralgia group (n=64), comparing the general data, MRI, and musculoskeletal ultrasound parameters between the two groups. Compared the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores of both groups. Conducted multiple linear regression analysis of MRI parameters and adjacent musculoskeletal functional indicators of the DRG. Used multivariate logistic regression analysis to identify independent risk factors affecting postherpetic neuralgia in patients. Constructed a restricted cubic spline model to analyze the dose-response relationship between MRI, musculoskeletal ultrasound parameters, adjacent musculoskeletal function of the DRG, and postherpetic neuralgia. Plotted the receiver operating characteristic curve (ROC) and calibration curve to assess the predictive accuracy of the model. Results The differences between the two groups of patients in terms of hypertension history and smoking are statistically significant (P<0.05). Patients with postherpetic neuralgia had significantly higher values in the surface volume ratio of the DRG, maximum 2D diameter pillar, median, large area high grayscale emphasized parameters, musculoskeletal ultrasound score (MUS), pain numerical rating scale score (NRS), ODI, and VAS compared to patients with herpes zoster neuralgia (P<0.001). The results of the multifactor logistic regression analysis showed that hypertension, smoking, surface volume ratio, maximum 2D diameter pillar, median, short-range low grayscale emphasis, large area high grayscale emphasis, MUS, and NRS are independent influencing factors for postherpetic neuralgia in patients (P<0.05). The results of the restricted cubic spline model analysis showed that there is a nonlinear dose-response relationship between MRI, musculoskeletal ultrasound parameters, adjacent muscle and bone function of the DRG, and the risk of developing postherpetic neuralgia. The ROC curve results showed an AUC of 0.859 (95% CI: 0.813~0.902), and the calibration curve Brier score was 0.087, indicating a high predictive ability of the model. Conclusion MRI combined with musculoskeletal ultrasound imaging features can assess the musculoskeletal function adjacent to the DRG in ZAP patients. The MRI and musculoskeletal ultrasound parameters are correlated with the functional parameters of the adjacent musculoskeletal structures to the DRG, and the model shows high discriminative ability and accuracy.