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Utility of Preoperative Shear-Wave Elastography of the Supraspinatus Muscle for Predicting Successful Rotator Cuff Repair: A Prospective Observational Study With MRI Correlation. AJR Am J Roentgenol 2022; 218:1051-1060. [PMID: 35043666 DOI: 10.2214/ajr.21.27129] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND. After rotator cuff tear, properties of the torn muscle predict failed surgical repair. OBJECTIVE. The purpose of our study was to explore the utility of preoperative shear-wave elastography (SWE) measurements of the supraspinatus muscle to predict successful rotator cuff repair, including comparison with MRI-based measures. METHODS. This prospective study included 74 patients (37 men, 37 women; mean age, 63.9 ± 10.0 [SD] years) who underwent rotator cuff repair between May 2019 and January 2021. Patients underwent preoperative clinical shoulder MRI and investigational shoulder ultrasound including SWE using shear modulus. The mean elasticity values of the supraspinatus and trapezius muscles were measured, and the elasticity ratio (i.e., ratio of mean elasticity of supraspinatus muscle to mean elasticity of trapezius muscle) was calculated. The muscular fatty infiltration score (1-3 scale) was recorded on gray-scale ultrasound. On MRI, muscular fatty infiltration was assessed by Goutallier grade (0-4 scale), and muscular atrophy was assessed by the occupation ratio (ratio of cross-sectional areas of supraspinatus muscle and supraspinatus fossa) and by the muscle atrophy grade (0-3 scale). After rotator cuff repair, the surgeon classified procedures as achieving sufficient (n = 60) or insufficient (n = 14) repair. RESULTS. Patients with insufficient repair, versus those with sufficient repair, more commonly exhibited a large (3-5 cm) tear (100.0% vs 50.0%). Patients with insufficient, versus sufficient, repair exhibited higher mean Goutallier grade (3.8 ± 0.4 vs 1.9 ± 1.1), mean muscle atrophy grade (2.0 ± 0.8 vs 0.5 ± 0.7), mean supraspinatus elasticity (44.15 ± 8.06 vs 30.84 ± 7.89 kPa), mean elasticity ratio (3.66 ± 0.66 vs 1.83 ± 0.58), and mean gray-scale fatty infiltration grade (2.86 ± 0.36 vs 1.63 ± 0.66) and showed lower mean occupation ratio (0.3 ± 0.1 vs 0.6 ± 0.1) (all, p < .001). AUC for predicting insufficient repair was 0.945 for Goutallier grade, 0.961 for occupation ratio, 0.900 for muscle atrophy grade, 0.874 for mean elasticity, 0.971 for elasticity ratio, and 0.912 for gray-scale fatty infiltration grade. Elasticity ratio (cutoff ≥ 2.51) achieved sensitivity of 100.0% and specificity of 90.0% for insufficient repair. At multivariable analysis including tear size, the three MRI measures, elasticity ratio, and gray-scale fatty infiltration grade, the only independent predictors of insufficient repair were muscle atrophy grade of 2-3 (odds ratio [OR] = 9.3) and elasticity ratio (OR = 15.7). CONCLUSION. SWE-derived elasticity is higher in patients with insufficient rotator cuff repair; the elasticity ratio predicts insufficient repair independent of tear size and muscle characteristics. CLINICAL IMPACT. Preoperative SWE may serve as a prognostic marker in patients with rotator cuff tear.
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Bedewi MA, Alhariqi BA, Aldossary NM, Gaballah AH, Sandougah KJ, Kotb MA. Shear wave elastography of the common fibular nerve at the fibular head. Medicine (Baltimore) 2022; 101:e29052. [PMID: 35356920 PMCID: PMC10684218 DOI: 10.1097/md.0000000000029052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 02/23/2022] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT The aim of this work is to study the sonoelastographic features of the common fibular nerve in healthy adult subjects.This is an observational cross-sectional study. Shear wave elastography was used to evaluate the common fibular nerve. Crosssectional area and stiffness were measured in kilopascal (kPa) and meters/second (m/s).The study included 82 common fibular nerves in 41 healthy adult subjects. The mean cross-sectional area of the common fibular nerve at the fibular head was 8.7 mm2. Positive correlation was noted between stiffness measurements between short and long axes by both methods. The mean stiffness of the common fibular nerve in the short axis was 22.5 kPa, and in the long axis (LA) was 35.4 kPa. Positive correlation was noted between height and stiffness measured by both methods in both axes by kPa. In m/s, the mean stiffness of the common fibular in the short axis was 2.6 m/s, and while in the LA was 3.4 m/s. Height showed positive correlation with both axes for stiff measurements in m\s. Weight showed positive correlation with stiffness measurements by m/s in the LA.The results obtained in our study could be a reference point for evaluating stiffness of the common fibular nerve in research involving different pathologies.
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Affiliation(s)
- Mohamed A. Bedewi
- Correspondence: Mohamed A. Bedewi, College of Medicine, Prince Sattam bin Abdulaziz University, P.O. Box 173, Al-kharj 11942, Kingdom of Saudi Arabia (e-mail: ).
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Quantifying Region-Specific Elastic Properties of Distal Femoral Articular Cartilage: A Shear-Wave Elastography Study. Appl Bionics Biomech 2022; 2022:9406863. [PMID: 35178122 PMCID: PMC8844102 DOI: 10.1155/2022/9406863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/30/2021] [Indexed: 11/22/2022] Open
Abstract
Knee osteoarthritis is a disease with the degeneration of articular cartilage as its main feature. Cartilage thickness cannot become a single index to evaluate cartilage degeneration, so it is essential to also evaluate the stiffness. The purposes were as follows: (1) to examine test-retest reliabilities of the elastic modulus measurement in distal femoral articular cartilage (FAC) and compare the changes in specific-regional of distal FAC, (2) to explore the difference in distal FAC stiffness and thickness between the dominant and nondominant sides, and (3) to examine the correlation between the elastic properties of cartilage and the thickness of cartilage. Twenty healthy participants were recruited. The stiffness of distal FAC at the lateral femoral condyle (LFC), medial femoral condyle (MFC), and intercondylar notch (IN) was quantified using shear-wave elastography (SWE). Intra- and interrater reliabilities were excellent for measuring the stiffness of distal FAC (ICC: 0.83-0.98). About a 50% increase in the stiffness of LFC (40.78 kPa) was found when compared with IN (21.82 kPa) and MFC (18.34 kPa). No significant difference was found between the dominant and nondominant sides in distal FAC stiffness and thickness. There was no correlation between the stiffness and thickness of the distal FAC. In conclusion, SWE can quantify the stiffness of the distal FAC.
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Sung JH, Kwon YJ, Baek SH, Son MH, Lee JH, Kim BJ. Utility of shear wave elastography and high-definition color for diagnosing carpal tunnel syndrome. Clin Neurophysiol 2021; 135:179-187. [PMID: 34963555 DOI: 10.1016/j.clinph.2021.10.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The diagnostic values of measuring median nerve (MN) stiffness and vascularity with shear wave elastography (SWE) and high-definition (HD) color were investigated in carpal tunnel syndrome (CTS). METHODS Seventy patients (123 wrists) with CTS and thirty-five healthy volunteers (70 wrists) were enrolled. Based on nerve conduction studies (NCS), the patients were subdivided into NCS-negative, mild-to-moderate, and severe CTS groups. MN and abductor pollicis brevis (APB) SWE and MN HD color were performed on a longitudinal plane. RESULTS The mild-to-moderate and severe CTS groups showed increased MN stiffness at the wrist and MN stiffness ratio (wrist-to forearm) compared with the control (p < 0.001). The NCS-negative CTS group showed increased MN stiffness at the wrist (p = 0.022) and MN stiffness ratio (p = 0.032) compared with the control. The severe CTS group showed increased MN stiffness at the wrist compared with the mild-to-moderate CTS group (p = 0.034). The cutoff-values in diagnosing NCS-confirmed CTS were 50.12 kPa for MN stiffness at the wrist, 1.91 for MN stiffness ratio, and grade 1 for HD color. CONCLUSIONS SWE and HD color are good supportive tools in diagnosing and assessing severity in CTS. SIGNIFICANCE SWE and HD color demonstrated that MN in CTS was associated with increased stiffness and hypervascularity.
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Affiliation(s)
- Joo Hye Sung
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Ye Ji Kwon
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Seol-Hee Baek
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Myeong Hun Son
- Neurophysiology Laboratory, Korea University Anam Hospital, Seoul, Republic of Korea.
| | - Jung Hun Lee
- Neurophysiology Laboratory, Korea University Anam Hospital, Seoul, Republic of Korea.
| | - Byung-Jo Kim
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea; BK21 FOUR Program in Learning Health Systems, Korea University, Seoul, Korea.
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García González P, Escoda Menéndez S, Meana Morís A. Elastografía en musculoesquelético. ¿Herramienta o juguete? RADIOLOGIA 2021. [DOI: 10.1016/j.rx.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Immediate Effect of Whole Body Vibration on Knee Extensor Tendon Stiffness in Hemiparetic Stroke Patients. ACTA ACUST UNITED AC 2021; 57:medicina57101037. [PMID: 34684074 PMCID: PMC8540205 DOI: 10.3390/medicina57101037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Whole body vibration is widely used to enhance muscle performance, but evidence of its effects on the tendon stiffness of the knee extensor tendon in stroke remains inconclusive. Our study was aimed to determine the difference in patellar and quadriceps tendon stiffness between hemiparetic and unaffected limbs in stroke patients and to investigate the immediate effect of whole body vibration on tendon stiffness. Materials and Methods: The patellar and quadriceps tendon stiffness of first-ever hemiplegic stroke patients was evaluated with elastography to compare the differences between hemiparetic and unaffected limbs. After one 20 min session of whole body vibration exercise in the standing position, tendon stiffness was again measured to evaluate the immediate effects of whole body vibration on tendon stiffness. Results: The results showed no significant differences in the tendon stiffness of the patellar and quadriceps tendons between hemiparetic and unaffected limbs. However, significant associations were found between the tendon stiffness of the patellar and quadriceps tendons and knee extensor spasticity on the hemiparetic side (ρ = 0.62; p = 0.044). There were no significant changes in tendon stiffness after a single session of whole body vibration. Conclusions: In conclusion, knee extensor tendon stiffness in hemiparetic limbs is positively correlated to the degree of knee extensor spasticity in stroke patients. However, a single session of whole body vibration does not alter tendon stiffness.
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Bedewi MA, Alhariqi BA, Aldossary NM, Gaballah AH, Sandougah KJ. Shear wave elastography of the scalene muscles in healthy adults: A preliminary study. Medicine (Baltimore) 2021; 100:e26891. [PMID: 34397912 PMCID: PMC8360440 DOI: 10.1097/md.0000000000026891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 07/19/2021] [Indexed: 01/04/2023] Open
Abstract
The aim of the study is to evaluate the reliability of shear wave elastography to assess the anterior and middle scalene muscles in healthy adult subjects.The study included 60 scalene muscles in 15 healthy subjects. High-resolution ultrasound and shear wave elastography were used to evaluate the anterior scalene and the middle scalene muscles. Stiffness values were measured.The mean shear elastic modulus showed the following values, right anterior scalene muscle 18.83 ± 5.32 kPa, left anterior scalene muscle 21.71 ± 4.8 kPa, right middle scalene muscle 12.84 ± 5.2 kPa, left middle scalene muscle 19.76 ± 5.30 kPa. Positive correlation was noted between the left middle scalene muscle and body mass index (P = .004). No difference in elasticity was noted between the right and left anterior scalene muscles; however, significant difference was noted between the right and left middle scalene muscles (P = .002).The results obtained in our study could be a reference point for future research considering different scalene muscle pathologies.
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Affiliation(s)
- Mohamed A. Bedewi
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Bader Abdullah Alhariqi
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Nasser M. Aldossary
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | | | - Kholoud J. Sandougah
- Department of Medicine, College of Medicine, Al Imam Mohammed Ibn Saud Islamic University, Riyadh, Kingdom of Saudi Arabia
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Chen PY, Yang TH, Kuo LC, Hsu HY, Su FC, Huang CC. Evaluation of Hand Tendon Elastic Properties During Rehabilitation Through High-Frequency Ultrasound Shear Elastography. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:2716-2726. [PMID: 33956629 DOI: 10.1109/tuffc.2021.3077891] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Tendon injuries lead to tendon stiffness, which impairs skeletal muscle movement. Most studies have focused on patellar or Achilles tendons by using ultrasound elastography. Only a few studies have measured the stiffness of hand tendons because their thickness is only 1-2 mm, rendering clinical ultrasound elastography unsuitable for mapping hand tendon stiffness. In this study, a high-frequency ultrasound shear elastography (HFUSE) system was proposed to map the shear wave velocity (SWV) of hand flexor tendons. A handheld vibration system that was coaxially mounted with an external vibrator on a high-frequency ultrasound (HFUS) array transducer allowed the operators to scan hand tendons freely. To quantify the performance of HFUSE, six parameters were comprehensively measured from homogeneous, two-sided, and three-sided gelatin phantom experiments: bias, precision, lateral resolution, contrast, contrast-to-noise ratio (CNR), and accuracy. HFUSE demonstrated an excellent resolution of [Formula: see text] to distinguish the local stiffness of thin phantom (thickness: 1.2 mm) without compromising bias, precision, contrast, CNR, and accuracy, which has been noted with previous systems. Human experiments involved four patients with hand tendon injuries who underwent ≥2 months of rehabilitation. Using HFUSE, two-dimensional SWV images of flexor tendons could be clearly mapped for healthy and injured tendons, respectively. The findings demonstrate that HFUSE can be a promising tool for evaluating the elastic properties of the injured hand tendon after surgery and during rehabilitation and thus help monitor progress.
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Effect of Resonant Frequency Vibration on Delayed Onset Muscle Soreness and Resulting Stiffness as Measured by Shear-Wave Elastography. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157853. [PMID: 34360146 PMCID: PMC8345543 DOI: 10.3390/ijerph18157853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/31/2022]
Abstract
This study utilized resonant frequency vibration to the upper body to determine changes in pain, stiffness and isometric strength of the biceps brachii after eccentric damage. Thirty-one participants without recent resistance training were randomized into three groups: a Control (C) group and two eccentric exercise groups (No vibration (NV) and Vibration (V)). After muscle damage, participants in the V group received upper body vibration (UBV) therapy for 5 min on days 1-4. All participants completed a visual analog scale (VAS), maximum voluntary isometric contraction (MVIC), and shear wave elastography (SWE) of the bicep at baseline (pre-exercise), 24 h, 48 h, and 1-week post exercise. There was a significant difference between V and NV at 24 h for VAS (p = 0.0051), at 24 h and 1-week for MVIC (p = 0.0017 and p = 0.0016, respectively). There was a significant decrease in SWE for the V group from 24-48 h (p = 0.0003), while there was no significant change in the NV group (p = 0.9341). The use of UBV resonant vibration decreased MVIC decrement and reduced VAS pain ratings at 24 h post eccentric damage. SWE was strongly negatively correlated with MVIC and may function as a predictor of intrinsic muscle state in the time course of recovery of the biceps brachii.
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Shear Wave Elastography of the Plantar Fascia: Comparison between Patients with Plantar Fasciitis and Healthy Control Subjects. J Clin Med 2021; 10:jcm10112351. [PMID: 34072045 PMCID: PMC8199455 DOI: 10.3390/jcm10112351] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/17/2022] Open
Abstract
Background: The purpose of this study was to evaluate plantar fasciae of healthy subjects and patients with plantar fasciitis by shear wave velocity (SWV) and stiffness with correlation to B-Mode and color Doppler ultrasonography (CDUS) and to establish cut-off values. Methods: This observational study was conducted with the approval of the Institutional Review Boards (IRBs) of our institution. 108 unilateral plantar fasciae were evaluated by including 87 consecutive patients (mean age 51.7; range: 29–82) (66 women and 21 men) with plantar fasciitis and 21 asymptomatic age matched healthy volunteers (mean age 47.3; range: 32–58) (15 women and 6 men). All patients were prospectively imaged between July 2018 and March 2019. B-mode US was used to measure thickness and CDUS to grade vascularity. SWE measurements were repeated 3 times and mean was used for statistical analysis. Results: Mean SWV value in healthy subjects was 6.94 m/s and in patients 4.98 m/s with a mean stiffness value of 152.88 kPa and 93.54 kPa respectively (p < 0.001). For SWV a cut-off value of 6.16 m/s had a specificity of 80.95% and sensitivity of 79.31%. For stiffness a cut-off value of 125.57 kPa had a specificity of 80.95% and sensitivity of 80.46%. No correlation to CDUS was found. The mean thickness of healthy fascias was 3.3 mm (range 2.4–3.9) compared to 6.1 mm (range 2.0–22.0) in plantar fasciitis (p < 0.001) with no correlation to SWV or to stiffness (r² = 0.02, p = 0.06). Conclusion: SWE allows quantitative assessment of plantar fascia stiffness, which decreases in patients with plantar fasciitis. No correlation to the thickness of the plantar fascia was found, therefore it represents an independent factor for the diagnosis of plantar fasciitis and could be helpful in addition to thickness measurement in unclear cases.
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Abstract
OBJECTIVE To determine the ability of shear wave elastography to measure the stiffness of the knee menisci in healthy adults. METHODS This observational cross-sectional study evaluated knee joints in healthy adults. Shear wave elastography was used to evaluate the anterior horn of the medial menisci bilaterally. The correlations between the mean elasticity bilaterally and age, weight, height and body mass index (BMI) were calculated using Pearson's correlation coefficient test. RESULTS A total of 34 knee joints in 17 healthy subjects were evaluated. The mean ± SD shear elastic modulus of the anterior horn of the right medial meniscus was 24.86 ± 6.35 kPa and of the anterior horn of the left medial meniscus was 23.86 ± 4.49 kPa. A significant inverse correlation was observed between the right medial meniscus elasticity and height. Other demographic factors showed no significant relationship to the anterior horn of the right medial meniscus elasticity. A significant inverse correlation was observed between the anterior horn of the left medial meniscus elasticity and age, while a significant positive correlation was observed between left medial meniscus elasticity and BMI. CONCLUSION These preliminary results suggest that shear wave elastography could be a potential tool to aid in studying the stiffness of the knee menisci.
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Affiliation(s)
- Mohamed A Bedewi
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Ayman A Elsifey
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Ayman K Saleh
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia.,Department of Orthopaedics, Faculty of Medicine for Girls, Alazhar University, Cairo, Egypt
| | - Tariq Alfaifi
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
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Bedewi MA, Kotb MA, Aldossary NM, Abodonya AM, Saleh AK, Swify SM. Shear wave elastography of the radial nerve in healthy subjects. J Int Med Res 2021; 49:300060520987938. [PMID: 33459089 PMCID: PMC7816536 DOI: 10.1177/0300060520987938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective This study was performed to examine the sonoelastographic features of the radial nerve in healthy subjects. Methods In this observational cross-sectional study, shear wave elastography was used to evaluate the radial nerve. The cross-sectional area and stiffness were measured. Results The study included 37 nerves in 20 healthy adult subjects. The mean cross-sectional area of the radial nerve at the arm was 6.1 mm2. The mean stiffness of the radial nerve in the short axis was 30.3 kPa, and that in the long axis was 34.9 kPa. The elasticity measurements were significantly different between the long axis and short axis. Conclusion The elastic modulus of the radial nerve was studied in healthy subjects and can serve as a reference for future assessment of different radial nerve pathologies.
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Affiliation(s)
- Mohamed A Bedewi
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Mamdouh A Kotb
- Neurology Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia.,Neurology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Nasser M Aldossary
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Ahmed M Abodonya
- Anesthesia and Intensive Care Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.,Surgery Department, College of Medicine, Prince Sattam bin Abdulaziz University, Kingdom of Saudi Arabia
| | - Ayman K Saleh
- Surgery Department, College of Medicine, Prince Sattam bin Abdulaziz University, Kingdom of Saudi Arabia.,Orthopedic Department, Faculty of Medicine for Girls, Alazhar University, Cairo
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Park EJ, Hahn S, Yi J, Shin KJ, Lee Y, Lee HJ. Comparison of the Diagnostic Performance of Strain Elastography and Shear Wave Elastography for the Diagnosis of Carpal Tunnel Syndrome. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:1011-1021. [PMID: 32852107 DOI: 10.1002/jum.15478] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/23/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To compare the diagnostic performance between strain elastography and shear wave elastography (SWE) for the diagnosis of carpal tunnel syndrome (CTS). METHODS Between July 2018 and June 2019, 66 consecutive patients with 95 imaged wrists underwent wrist ultrasound, including grayscale ultrasound, strain elastography, and SWE, because of the suspicion of CTS. During wrist ultrasound, the cross-sectional area (CSA), strain ratio, elasticity, and shear wave velocity of each median nerve were measured at the proximal carpal bone level (scaphoid to pisiform). The variables were compared between the normal and CTS groups by using the independent t test, and subgroup analyses were performed using one-way analysis of variance. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of each variable. RESULTS CSA, elasticity, and shear wave velocity showed significant intergroup differences (P < 0.001, P < 0.001, and P = 0.002, respectively). However, the strain ratio showed no statistically significant intergroup difference (P = 0.639). In the subgroup analyses, elasticity showed significantly higher values in the severe group than in the mild and moderate groups (P < 0.001 and P = 0.001, respectively). Other parameters showed no significant differences among the different subgroups. The areas under the ROC curve were 0.823 for CSA, 0.772 for elasticity, and 0.779 for shear wave velocity. The differences in the areas under the ROC curve among CSA, elasticity, and shear wave velocity were not statistically significant (all P > 0.05). CONCLUSIONS SWE has a good diagnostic value in CTS. In particular, elasticity can discriminate the severe group from the other groups.
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Affiliation(s)
- Eun Joo Park
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan, 48108, Republic of Korea
| | - Seok Hahn
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan, 48108, Republic of Korea
| | - Jisook Yi
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan, 48108, Republic of Korea
| | - Kyong Jin Shin
- Department of Neurology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan, 48108, Republic of Korea
| | - Yedaun Lee
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan, 48108, Republic of Korea
| | - Ho-Joon Lee
- Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, 875 Haeundae-ro, Haeundae-gu, Busan, 48108, Republic of Korea
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Kawai T, Takahashi M, Takamoto K, Bito I. Hamstring strains in professional rugby players result in increased fascial stiffness without muscle quality changes as assessed using shear wave elastography. J Bodyw Mov Ther 2021; 27:34-41. [PMID: 34391255 DOI: 10.1016/j.jbmt.2021.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 12/18/2020] [Accepted: 03/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Hamstring strain injury is common among sports injuries. A previous history of this injury is considered a strong predictor of recurrent hamstring strain injury. Fascial tissue reportedly becomes stiffer after hamstring strain injury. However, the association between fascial stiffness and previous hamstring strain injury has not been investigated in clinical studies. We aimed to determine whether a previous history of hamstring strain injury affects fascial tissue and muscle tissues using shear wave elastography. METHOD In eleven male professional rugby players, the stiffness as a shear modulus (kPa) of fascial tissue and muscle was measured on the specific injured area measured by magnetic resonance imaging (MRI) at resting position by using shear wave elastography. The side-to-side differences between the injured and the uninjured side were analyzed. The length and area of the muscle scar tissue were evaluated by MRI in relation to fascial stiffness. RESULTS The shear elastic modulus of fascia was stiffer in the injured vs. the uninjured side; however, no difference was observed in the muscle. No significant relationship was detected between the length and area of the muscle scar tissue (all P > 0.05). DISCUSSION Rugby players with a previous history of hamstring strain injury exhibited passive stiffness of fascial tissues in the injured leg, regardless of the length or area of the muscle scar tissue. However, the passive stiffness of muscles was same between the injured and the uninjured leg. CONCLUSION The results can be beneficial to consider future risk for hamstring strain injuries.
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Affiliation(s)
- Tomonori Kawai
- Department of Sports and Health Sciences, Faculty of Human Sciences, University of East Asia, Ichinomiya Gakuen Cyo, Shimonoseki, Yamaguchi, Japan.
| | - Masayasu Takahashi
- Konan Medical Center, Department of Orthopaedic Surgery, Hyogo, Japan 1-5-16 Kamokogahara Higashinada, Kobe, Hyogo, Japan
| | - Kouichi Takamoto
- Department of Sports and Health Sciences, Faculty of Human Sciences, University of East Asia, Ichinomiya Gakuen Cyo, Shimonoseki, Yamaguchi, Japan.
| | - Itsumu Bito
- Department of Sports and Health Sciences, Faculty of Human Sciences, University of East Asia, Ichinomiya Gakuen Cyo, Shimonoseki, Yamaguchi, Japan
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Bedewi MA, Elsifey AA, Alfaifi T, Saleh AK, Swify SM, Sandougah KJ. Shearwave elastography of the Sartorius muscle. Medicine (Baltimore) 2021; 100:e25196. [PMID: 33726013 PMCID: PMC7982227 DOI: 10.1097/md.0000000000025196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 02/18/2021] [Indexed: 01/05/2023] Open
Abstract
The aim of the study was to study sonoelastographic features of thesartorius muscle, and its relation to the demographic factors.The study included 70 muscles in 35 healthy subjects. High-resolution ultrasound and shearwave elastography were used to evaluate the sartorius muscle. Stiffness values were measured.The mean shear elastic modulus of the sartorius muscle was 21.96 ± 5.1 kPa. Demographic factors showed no relation to the elastic modulus of the left sartorius muscle. Positive statistical correlation was noted between the elastic modulus of the right sartorius muscle, weight, and body mass index.Our results could be a reference point for evaluating sartorius muscle stiffness in future research considering different pathologies.
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Affiliation(s)
| | | | | | - Ayman K. Saleh
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
- Orthopedic Department, Faculty of Medicine for Girls, Alazhar University, Cairo
| | | | - Kholoud J. Sandougah
- Department of Medicine, College of Medicine, Al Imam Mohammed Ibn Saud Islamic University, Riyadh, Kingdom of Saudi Arabia
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Laubach M, Hellmann JT, Dirrichs T, Gatz M, Quack V, Tingart M, Betsch M. Anterior knee pain after total knee arthroplasty: A multifactorial analysis. J Orthop Surg (Hong Kong) 2021; 28:2309499020918947. [PMID: 32338135 DOI: 10.1177/2309499020918947] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Dissatisfaction and an impaired quality of life after total knee arthroplasty (TKA) is often associated with postsurgical anterior knee pain (AKP). The underlying pathological mechanisms are not yet fully understood. Therefore, a multifactorial approach encompassing clinical and radiological parameters seemed reasonable and promising to investigate postsurgical AKP. METHODS In this cross-sectional study, 25 patients without and 25 patients with postsurgical AKP after unilateral TKA were randomly recruited from a larger cohort of patients. Multiple clinical and radiological parameters-including real-time shear wave elastography (SWE) to measure the patellar and quadriceps tendon elasticity-were acquired and subsequently associated with AKP. For statistical analysis, SPSS (IBM, version 25) was used. RESULTS In total 50 participants (58.0% men, mean age 63.42 years, mean body mass index 29.75 kg/m2), having different prosthetic designs implanted, were included. Independently of key covariates, the strength of the quadriceps muscle (p = 0.021), a thinner inlay (p = 0.041), and a lower position of the patella (p = 0.041) were associated with AKP. Although no correlation with AKP was found (p = 0.346, resp. p = 0.154), we observed significantly decreased Young's modulus of the patellar and quadriceps tendons for the involved knee compared to the uninvolved knee (p < 0.001). CONCLUSION In conclusion, quadriceps muscle strength, inlay thickness, and the patella position might be of particular relevance in avoiding postsurgical AKP. Future studies with larger sample sizes are needed to clarify the impact of quadriceps muscle strength and the postoperative patella position as well as the role of SWE as a personalized modifiable prediction marker.
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Affiliation(s)
- Markus Laubach
- Department of Orthopaedics, RWTH Aachen University Hospital, Aachen, Germany
| | - Julian Tr Hellmann
- Department of Orthopaedics, RWTH Aachen University Hospital, Aachen, Germany
| | - Timm Dirrichs
- Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, Aachen, Germany
| | - Matthias Gatz
- Department of Orthopaedics, RWTH Aachen University Hospital, Aachen, Germany
| | - Valentin Quack
- Department of Orthopaedics, RWTH Aachen University Hospital, Aachen, Germany
| | - Markus Tingart
- Department of Orthopaedics, RWTH Aachen University Hospital, Aachen, Germany
| | - Marcel Betsch
- Department of Orthopaedics, RWTH Aachen University Hospital, Aachen, Germany
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Bedewi MA, Elsifey AA, Alfaifi T, Kotb MA, Abdelgawad MS, Bediwy AM, Swify SM, Awad EM. Shear wave elastography of the tibial nerve in healthy subjects. Medicine (Baltimore) 2021; 100:e23999. [PMID: 33545992 PMCID: PMC7837829 DOI: 10.1097/md.0000000000023999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 11/25/2020] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study is to investigate sonoelastographic features of the tibial nerve.The study included 72 tibial nerves in 36 healthy subjects. High resolution ultrasound and Shear wave elastography were used to evaluate the tibial nerve. Cross sectional area and stiffness were measured.The mean cross sectional area of the tibial nerve was 13.4 mm2. The mean shear elastic modulus of the tibial nerve in the short axis was 23.3 kPa. The mean shear elastic modulus of the tibial nerve in long axis was 26.1 kPa. The tibial nerve elastic modulus also showed no correlation with cross sectional area neither in the long axis nor short axis. Age, height, weight, and body mass index showed no correlation with tibial nerve elastic modulus in short or long axes.The elastic modulus of the tibial nerve has been determined in healthy subjects and can serve as a reference for future assessment of polyneuropathy.
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Affiliation(s)
| | | | | | - Mamdouh A. Kotb
- Neurology Department, College of Medicine, Prince Sattam Bin Abdulaziz university, Al-Kharj, Kingdom of Saudi Arabia
- Neurology Department, Faculty of Medicine, Minia University, Minia
| | | | | | | | - Ezzat M. Awad
- Department of Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Institute for Specific Prophylaxis and Tropical Medicine [ISPTM], Center for Pathophysiology, Infectiology
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68
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Bedewi MA, Kotb MA, Aldossary NM, Abodonya AM, Alhariqi BA, Swify SM. Shear wave elastography of the ulnar nerve at the forearm. Medicine (Baltimore) 2021; 100:e24071. [PMID: 33466166 PMCID: PMC7808468 DOI: 10.1097/md.0000000000024071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 12/03/2020] [Indexed: 01/05/2023] Open
Abstract
The study included 38 ulnar nerves in 20 healthy subjects. High-resolution ultrasound and Shear wave elastography were used to evaluate the ulnar nerve at the mid forearm. The mean cross-sectional area of the ulnar nerve was 7.1 mm2. The mean shear elastic modulus of the nerve in the short axis was 27.4 kPa. The mean shear elastic modulus of the nerve in long axis was 24.7 kPa. No statistical relation could be noted between elasticity measurements in long and short axes. The ulnar nerve elastic modulus also showed no correlation with CSA neither in the long axis nor short axis. Age, height, weight, and body mass index showed no correlation with the ulnar elastic modulus in short or long axes. The elastic modulus of the ulnar nerve has been determined in healthy subjects and can serve as a reference for future assessment of compressive neuropathies of the ulnar nerve.
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Affiliation(s)
- Mohamed Abdelmohsen Bedewi
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Mamdouh A. Kotb
- Neurology Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
- Neurology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Nasser M. Aldossary
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Ahmed M. Abodonya
- Anesthesia and Intensive Care Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Surgery Department, College of Medicine, Prince Sattam bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Bader A. Alhariqi
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
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Del Signore F, De Dominicis S, Mastromatteo G, Simeoni F, Scapolo PA, Tamburro R, Vignoli M. Sonoelastography of Normal Canine Common Calcaneal Tendon: Preliminary Results. Vet Comp Orthop Traumatol 2020; 34:200-205. [PMID: 33302314 DOI: 10.1055/s-0040-1721660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Shear wave elastography (SWE) is a feasible and newly developed ultrasonographic technique which is able to assess elasticity of tissues. The aim of this work was to assess the feasibility of SWE on the normal canine common calcaneal tendon (CCT) evaluating the intra-operator repeatability and reproducibility of single measurements and stiffness of different anatomic CCT portions was examined. Tendons were first evaluated with B-mode ultrasound with a linear probe 8.5 to 10 MHz in longitudinal section with slight flexed tarsocrural joint and a gel-pad. Common calcaneal tendon was divided into three different anatomical regions. Shear wave elastography was performed in each region by two operators and quantitative evaluation (m/s and kPa) was performed on the most representative images. Region of interest (0.15 cm) was settled. Intraclass correlation coefficient (ICC) results were classified using the following scale: 0.00 to 0.20 = poor; 0.20 to 0.40 = fair; 0.40 to 075 = good; >0.75 = excellent. Ten adult dogs were enrolled. Intra-operator ICC values were >0.75 for both operators in every tendon portion. Inter-operator SWE ICC values for m/s measurements were 0.3, 0.61 and 0.61 for the enthesis, intermediate portion and the myotendinous junction respectively; for kPa measurements, values were respectively 0.3, 0.7 and 0.81. The three CCT portions were significantly different in stiffness (p-value < 0.001 for both m/s and kPa measurements). These preliminary results provide evidence that SWE is potentially appliable to assess mechanical properties of canine CCT affected by tendinopathies.
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Affiliation(s)
- Francesca Del Signore
- Department of Medicine, Faculty of Veterinary Medicine, University of Teramo, Piano D'Accio, Teramo, Italy
| | - Stefania De Dominicis
- Department of Medicine, Faculty of Veterinary Medicine, University of Teramo, Piano D'Accio, Teramo, Italy
| | - Giovanni Mastromatteo
- Department of Medicine, Faculty of Veterinary Medicine, University of Teramo, Piano D'Accio, Teramo, Italy
| | - Francesco Simeoni
- Department of Medicine, Faculty of Veterinary Medicine, University of Teramo, Piano D'Accio, Teramo, Italy
| | - Pier Augusto Scapolo
- Department of Medicine, Faculty of Veterinary Medicine, University of Teramo, Piano D'Accio, Teramo, Italy
| | - Roberto Tamburro
- Department of Medicine, Faculty of Veterinary Medicine, University of Teramo, Piano D'Accio, Teramo, Italy
| | - Massimo Vignoli
- Department of Medicine, Faculty of Veterinary Medicine, University of Teramo, Piano D'Accio, Teramo, Italy
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Abstract
OBJECTIVE. The purpose of this article is to cover technical advances in musculo-skeletal ultrasound from the viewpoint of the radiologist. CONCLUSION. Among the advances in musculoskeletal ultrasound that we highlight the use of ultrahigh-frequency transducers to visualize ever-finer anatomic detail, the expanding practical clinical applications for microvascular imaging, and the use of elastography to predict function and, possibly, healing potential.
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Bastijns S, De Cock AM, Vandewoude M, Perkisas S. Usability and Pitfalls of Shear-Wave Elastography for Evaluation of Muscle Quality and Its Potential in Assessing Sarcopenia: A Review. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2891-2907. [PMID: 32843232 DOI: 10.1016/j.ultrasmedbio.2020.06.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 06/18/2020] [Accepted: 06/30/2020] [Indexed: 05/08/2023]
Abstract
Sarcopenia is age-related progressive and generalized loss of skeletal muscle mass and strength. Its prevalence is rising, which poses a burden for society because it increases disability and dependency and therefore raises health care costs. Muscle mass quality, however-an essential part of sarcopenia-is not easily diagnosable yet. Recent interest has risen for ultrasonographic evaluation of muscle. This review introduces muscle elastography as a possible, easy and cheap tool to evaluate qualitative muscle parameters. Basic principles of muscle elastography are described, as well as different elastography techniques and some technical considerations. Furthermore, a proposal for practical guidelines is offered and factors influencing muscle stiffness are highlighted.
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Affiliation(s)
- Sophie Bastijns
- Department of Medicine, University of Antwerp, Antwerp, Belgium; Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium.
| | - Anne-Marie De Cock
- Department of Medicine, University of Antwerp, Antwerp, Belgium; Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium
| | - Maurits Vandewoude
- Department of Medicine, University of Antwerp, Antwerp, Belgium; Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium; Belgian Ageing Muscle Society, Liege, Belgium
| | - Stany Perkisas
- Department of Medicine, University of Antwerp, Antwerp, Belgium; Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium; Belgian Ageing Muscle Society, Liege, Belgium
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Liu X, Yu HK, Sheng SY, Liang SM, Lu H, Chen RY, Pan M, Wen ZB. Quantitative evaluation of passive muscle stiffness by shear wave elastography in healthy individuals of different ages. Eur Radiol 2020; 31:3187-3194. [PMID: 33052467 DOI: 10.1007/s00330-020-07367-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/27/2020] [Accepted: 10/01/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To investigate age-related changes on passive muscle stiffness in healthy individuals and measure the shear modulus in different age groups. METHODS Shear wave elastography (SWE) movies of gastrocnemius medialis (GM) were collected during passive stretching induced by ankle rotation from plantarflexion (PF) to dorsiflexion (DF). A series of SWE images at ankle angles of PF 40°, PF 30°, PF 20°, PF 10°, 0°, DF 10°, DF 20°, and DF 30° were collected and shear moduli measured accordingly for analyses. RESULTS Eighty-six healthy volunteers (27 children, 31 middle-aged adults, and 28 older people) were recruited. No significant difference was observed in the shear modulus between the three groups at ankle angles of PF 40°, PF 30°, PF 20°, PF 10°, and 0° (p > 0.05). The difference in the shear modulus among the three groups became significant as DF increased. At ankle angles of DF 10°, DF 20°, and DF 30°, the shear modulus was the greatest in the older group, followed by the middle-aged group and then the children group (p = 0.007, 0.000, and 0.000, respectively). CONCLUSIONS Passive muscle stiffness increases with age, and the difference between age groups was pronounced only after reaching a certain degree of stretching. KEY POINTS • The influence of age on passive muscle stiffness becomes pronounced only after reaching a certain degree of stretching. • Age should be considered when evaluating passive muscle stiffness in muscular disorders.
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Affiliation(s)
- Xiao Liu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, 253, Gongye Avenue, Guangzhou, 510282, Guangdong, China
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine, 6001, Beihuan Avenue, Shenzhen, 518034, Guangdong, China
| | - Hong-Kui Yu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, 253, Gongye Avenue, Guangzhou, 510282, Guangdong, China
| | - Shu-Ya Sheng
- Shenzhen Middle School, Shenzhen, Guangdong, China
| | - Si-Min Liang
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine, 6001, Beihuan Avenue, Shenzhen, 518034, Guangdong, China
| | - Hao Lu
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine, 6001, Beihuan Avenue, Shenzhen, 518034, Guangdong, China
| | - Rui-Yun Chen
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine, 6001, Beihuan Avenue, Shenzhen, 518034, Guangdong, China
| | - Min Pan
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine, 6001, Beihuan Avenue, Shenzhen, 518034, Guangdong, China.
| | - Zhi-Bo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, 253, Gongye Avenue, Guangzhou, 510282, Guangdong, China.
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Bedewi MA, Elsifey AA, Kotb MA, Bediwy AM, Ahmed YM, Swify SM, Abodonya AM. Shear wave elastography of the saphenous nerve. Medicine (Baltimore) 2020; 99:e22120. [PMID: 32925760 PMCID: PMC7489694 DOI: 10.1097/md.0000000000022120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The purpose of this study is to study sonoelastographic features of the saphenous nerve.The study included 72 saphenous nerves in 36 healthy subjects. High resolution ultrasound and Shearwave elastography were used to evaluate the saphenous nerve. Cross sectional area (CSA) and stiffness were measured.The mean CSA of the saphenous nerve was 5.7 mm. The mean shear elastic modulus of the saphenous nerve in the short axis was 29.5 kPa. The mean shear elastic modulus of the saphenous nerve in long axis was 29.9 kPa. The saphenous nerve elastic modulus also showed no correlation with CSA in neither the long axis nor short axis. Positive correlation between elasticity measurements in the long and short axes. Age, height, weight, and BMI showed no correlation with saphenous nerve elastic modulus in short or long axes.The elastic modulus of the saphenous nerve has been determined in healthy subjects and can serve as a reference for future assessment of the saphenous nerve before different procedures.
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Affiliation(s)
| | - Ayman A. Elsifey
- Department of Internal Medicine, Prince Sattam Bin Abdulaziz university, College of Medicine
| | - Mamdouh A. Kotb
- Neurology Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
- Neurology Department, Faculty of Medicine, Minia University, Minia
| | | | | | | | - Ahmed M. Abodonya
- Anesthesia and Intensive Care Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Surgery Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
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Jung JW, Je H, Lee SK, Jang Y, Choi J. Two-Dimensional Shear Wave Elastography of Normal Soft Tissue Organs in Adult Beagle Dogs; Interobserver Agreement and Sources of Variability. Front Bioeng Biotechnol 2020; 8:979. [PMID: 32974311 PMCID: PMC7466577 DOI: 10.3389/fbioe.2020.00979] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/27/2020] [Indexed: 12/21/2022] Open
Abstract
Shear wave elastography (SWE) induces lateral shear wave through acoustic pulses of the transducer and evaluates tissue stiffness quantitatively. This study was performed to evaluate feasibility and reproducibility of two-dimensional shear wave elastography (2D SWE) for evaluation of tissue stiffness and to examine technical factors that affect shear wave speed (SWS) measurements in adult dogs. Nine healthy, 2 year-old, adult beagles with the median weight of 9.8 kg were included. In this prospective, experimental, exploratory study, 2D SWE (Aplio 600) from the liver, spleen, kidneys, pancreas, prostate, lymph nodes (submandibular, retropharyngeal, axillary, medial iliac, and inguinal), submandibular salivary gland, and thyroid was performed in anesthetized beagles. Color map was drawn and SWS of each SWE were measured as Young’s modulus (kPa) and shear wave velocity (m/s). The effect of measuring site, scan approach, depth, and anesthesia on SWE was assessed in abdominal organs by two observers independently. A total of 27 SWE examinations were performed in 12 organs by each observer. All SWS measurements were preformed successfully; however, SWE in the renal medulla could not be successfully conducted, and it was excluded from further analysis. Interobserver agreement of SWE was moderate to excellent in all organs, except for the left liver lobe at 10–15 mm depth with the intercostal scan. In the liver, there was no significant effect of the measuring site and scan approach on SWE. SWS of the liver and spleen tended to be higher with increasing the depth, but no significant difference. However, anesthesia significantly increased tissue stiffness in the spleen compared to awake dog regardless of the depth (P < 0.05). There was a significant difference in SWS according to the measuring site in the kidneys and pancreas (P < 0.001). 2D SWE was feasible and highly reproducible for the estimation of tissue stiffness in dogs. Measuring site and anesthesia are sources of variability affecting SWE in abdominal organs. Therefore, these factors should be considered during SWS measurement in 2D SWE. This study provides basic data for further studies on 2D SWE on pathological conditions that may increase tissue stiffness in dogs.
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Affiliation(s)
- Jin-Woo Jung
- College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, South Korea
| | - Hyejin Je
- College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, South Korea
| | - Sang-Kwon Lee
- College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, South Korea
| | - Youjung Jang
- College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, South Korea
| | - Jihye Choi
- College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju, South Korea
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Gao J, Caldwell J, Wells M, Park D. Ultrasound Shear Wave Elastography to Assess Tissue Mechanical Properties in Somatic Dysfunction: A Feasibility Study. J Osteopath Med 2020; 120:2765212. [PMID: 32761168 DOI: 10.7556/jaoa.2020.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
CONTEXT Diagnosis of somatic dysfunction is based on subjective palpatory osteopathic assessments. This subjectivity has posed a challenge for researchers in studying osteopathic medicine. The development and use of radiological imaging techniques to objectively confirm or quantify muscle tissue stiffness associated with somatic dysfunction could be of benefit in osteopathic clinical practice, training, and further research. OBJECTIVES To investigate the feasibility of ultrasound shear wave elastography (SWE) to quantify muscle tissue stiffness in somatic dysfunction before and after osteopathic manipulative treatment (OMT). METHODS In this prospective study, we assessed lumbar spine somatic dysfunction in 20 adult patients before and after a single OMT session using standard osteopathic palpatory assessments by osteopathic physician faculty members in the Department of Osteopathic Principle and Practice at Rocky Vista University College of Osteopathic Medicine (Utah campus). Shear wave velocity (SWV, m/s) was measured in lumbar paraspinal muscle tissue using a commercial ultrasonography scanner on all participants immediately before and after OMT. In this study, OMT techniques targeted the iliocostalis lumborum and included the articulatory technique, balanced ligamentous tension, facilitated positional release, high-velocity, low-amplitude technique, muscle energy, myofascial release, and the Still technique at the discretion of the osteopathic physician. The difference in SWV between muscle tissues with and without dysfunction, and differences in SWV of dysfunctional tissue before and after OMT were examined using unpaired and paired t tests, as appropriate. The correlation between SWV measurements and osteopathic assessments was examined by the Spearman rank correlation. Intra- and interobserver reliability was analyzed using intraclass correlation coefficient. RESULTS The difference in SWV between muscle tissues with and without somatic dysfunction was significant before OMT (mean [SD], 1.93 [0.44] vs 1.69 [0.19]; P=.03) and was not significant after OMT (mean [SD], 1.69 [0.19] vs 1.53 [0.31]; P=.05). The difference in SWV in the same tissue with somatic dysfunction before and after OMT was significant (mean [SD], 1.93 [0.44] vs 1.52 [0.3]; P<.001). The SWV value highly correlated with manual osteopathic assessments (r=0.72). Intra- and interobserver reliability for performing SWE in somatic dysfunction was good (intraclass correlation coefficient >0.80). CONCLUSIONS The results of this study show that ultrasound SWE can objectively assess muscle tissue stiffness for diagnosis of somatic dysfunctions and for muscle tissue stiffness changes after OMT.
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Quack V, Betsch M, Hellmann J, Eschweiler J, Schrading S, Gatz M, Rath B, Tingart M, Laubach M, Kuhl CK, Dirrichs T. Evaluation of Postoperative Changes in Patellar and Quadriceps Tendons after Total Knee Arthroplasty-A Comprehensive Analysis by Shear Wave Elastography, Power Doppler and B-mode Ultrasound. Acad Radiol 2020; 27:e148-e157. [PMID: 31526688 DOI: 10.1016/j.acra.2019.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 02/04/2023]
Abstract
RATIONALE AND OBJECTIVES Up to now, the diagnosis of tendinopathies is based on conventional B-mode-ultrasound (B-US), Power Doppler-ultrasound (PD-US), and magnetic resonance imaging. In the past decade, Shear Wave Elastography (SWE) has been introduced in tendon imaging, for example in athletes or patients suffering from tendinopathy. SWE allows real-time quantification of tissue stiffness, and, by this, the assessment of the mechanical properties of a tendon and its changes during acute disease and tendon healing. So far there are no ultrasound-based studies that have evaluated postoperative tendon changes, anatomical and mechanical properties and tendon healing of the patellar, and quadriceps tendon following Total Knee Arthroplasty (TKA). The purpose of this prospective study was two-fold: first to analyze morphologic, vascular, and mechanical properties of patellar and quadriceps tendons in patients following TKA; and, second to evaluate possible changes thereof and their visibility in the course of time. MATERIALS AND METHODS Observational cross-sectional, IRB-approved study in 63 postoperative patients with a total of 76 total knee arthroplasties (50 unilateral, 13 bilateral) and 50 nonoperated knees for comparison, resulting in 152 postoperative patellar- and quadriceps and 100 nonoperated patellar- and quadriceps-tendons for comparative analysis. For further examination, we divided the 63 patients into two groups according to the duration since surgery (group A < 24 months; group B > 24 months). All patients completed a standardized questionnaire, furthermore the Knee Society score and the Knee Society function score. The amount of experienced pain was assessed using the ordinal numeric rating scale and the presence of anterior knee pain was examined. Subsequently every participant underwent a standardized multimodal ultrasound protocol consisting of B-US, PD-US, and SWE of the left and right patellar and quadriceps tendons. RESULTS Using the different US-modalities, operated patellar, and quadriceps tendons (n = 152) were significantly more frequent classified as pathological (B-US) (p < 0.001), the mean Ohberg score was significantly higher (PD-US) (p < 0.001), and the tendons were significantly softer (SWE) than their nonoperated counterparts (n = 100). Mean SWE-value of postoperative patellar tendons was 45.66 ± 14.84 kPa versus 60.08 ± 19.13 kPa in nonoperated knees (p < 0.001). Mean SWE-value of postoperative quadriceps tendons was 35.73 ± 15.66 kPa versus 52.69 ± 16.20 kPa in nonoperated knees (p < 0.001). Comparing the two postoperative groups (group A and B), we recognized a significant decrease of pathologically classified patellar and quadriceps tendons (B-US and PD-US) in group B. The early postoperatively reduced SWE values slightly increased during the course of time. CONCLUSION After TKA, patellar, and quadriceps tendons show significant measurable alterations in B-US, PD-US, and SWE. Especially a significant decrease of tendon stiffness in operated knees, as assessed by SWE, might be a surrogate marker for changed mechanical properties. These alterations improve, the longer ago the surgery was. The quantitative information obtained by SWE could be of particular interest in follow-up and therapy monitoring after TKA. Knowledge about tendon stiffness and it's varieties in different population groups (e.g. athletes, elderly, postoperative patients) is crucial to sonographically rate a tendon as "healthy" or "diseased."
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Affiliation(s)
- Valentin Quack
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Marcel Betsch
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Julian Hellmann
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Jörg Eschweiler
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Simone Schrading
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstraße 30, Aachen 52074, Germany
| | - Matthias Gatz
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Björn Rath
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Markus Tingart
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Markus Laubach
- Department of Orthopedics, University Hospital RWTH Aachen, Aachen, Germany
| | - Christiane K Kuhl
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstraße 30, Aachen 52074, Germany
| | - Timm Dirrichs
- Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Pauwelsstraße 30, Aachen 52074, Germany.
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Alrashed AI, Alfuraih AM. Reproducibility of shear wave elastography among operators, machines, and probes in an elasticity phantom. Ultrasonography 2020; 40:158-166. [PMID: 32660213 PMCID: PMC7758105 DOI: 10.14366/usg.20011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 05/09/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE This study was aimed to investigate the reproducibility of shear wave elastography (SWE) among operators, machines, and probes in a phantom, and to evaluate the effect of depth of the embedded inclusions and the accuracy of the measurements. METHODS In vitro stiffness measurements were made of six inclusions (10, 40, and 60 kPa) embedded at two depths (1.5 cm and 5 cm) in an elastography phantom. Measurements were obtained by two sonographers using two ultrasound machines (the SuperSonic Imagine Aixplorer with the XC6-1, SL10-2 and SL18-5 probes, and the General Electric LOGIQ E9 with the 9L-D probe). Variability was evaluated using the coefficient of variation. Reproducibility was calculated using intraclass correlation coefficients (ICCs). RESULTS For shallow inclusions, low variability was observed between operators (range, 0.9% to 5.4%). However, the variability increased significantly for deep inclusions (range, 2.4% to 80.8%). The measurement difference between the operators was 1%-15% for superficial inclusions and 3%-43% for deep inclusions. Inter-operator reproducibility was almost perfect (ICC>0.90). The measurement difference between machines was 0%-15% for superficial inclusions and 38.6%-82.9% for deep inclusions. For superficial inclusions, the reproducibility among the three probes was excellent (ICC>0.97). The mean stiffness values of the 10 kPa inclusion were overestimated by 16%, while those of the 40 kPa and 60 kPa inclusions were underestimated by 42% and 48%, respectively. CONCLUSION Phantom SWE measurements were only reproducible among operators, machines, and probes at superficial depths. SWE measurements acquired in deep regions should not be used interchangeably among operators, machines, or probes.
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Affiliation(s)
- Abdulaziz Ibrahim Alrashed
- Radiodiagnostics and Medical Imaging Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdulrahman M Alfuraih
- Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Kharj, Saudi Arabia
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Chalchat E, Gennisson JL, Peñailillo L, Oger M, Malgoyre A, Charlot K, Bourrilhon C, Siracusa J, Garcia-Vicencio S. Changes in the Viscoelastic Properties of the Vastus Lateralis Muscle With Fatigue. Front Physiol 2020; 11:307. [PMID: 32390859 PMCID: PMC7194212 DOI: 10.3389/fphys.2020.00307] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/19/2020] [Indexed: 12/31/2022] Open
Abstract
We investigated the in vivo effects of voluntary fatiguing isometric contractions of the knee extensor muscles on the viscoelastic properties of the vastus lateralis (VL). Twelve young males (29.0 ± 4.5 years) performed an intermittent voluntary fatigue protocol consisting of 6 sets × 10 repetitions of 5-s voluntary maximal isometric contractions with 5-s passive recovery periods between repetitions. Voluntary and evoked torque were assessed before, immediately after, and 20 min after exercise. The shear modulus (μ) of the VL muscle was estimated at rest and during a ramped isometric contraction using a conventional elastography technique. An index of active muscle stiffness was then calculated (slope from the relationship between shear modulus and absolute torque). Resting muscle viscosity (η) was quantified using a shear-wave spectroscopy sequence to measure the shear-wave dispersion. Voluntary and evoked torque decreased by ∼37% (P < 0.01) immediately after exercise. The resting VL μ was lower at the end of the fatigue protocol (-57.9 ± 5.4%, P < 0.001), whereas the resting VL η increased (179.0 ± 123%, P < 0.01). The active muscle stiffness index also decreased with fatigue (P < 0.05). By 20 min post-fatigue, there were no significant differences from the pre-exercise values for VL η and the active muscle stiffness index, contrary to the resting VL μ. We show that the VL μ is greatly reduced and η greatly enhanced by fatigue, reflecting a more compliant and viscous muscle. The quantification of both shear μ and η moduli in vivo may contribute to a better understanding of the mechanical behavior of muscles during fatigue in sports medicine, as well as in clinical situations.
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Affiliation(s)
- Emeric Chalchat
- Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Jean-Luc Gennisson
- BIOMAPS, Laboratoire d'Imagerie Biomédicale Multi-Modale, CEA, Université Paris-Saclay, CNRS UMR 9011, INSERM UMR 1281, Orsay, France
| | - Luis Peñailillo
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Finis Terrae University, Santiago, Chile
| | - Myriam Oger
- Unité Imagerie, Département des Plateformes et Recherche Technologique, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Alexandra Malgoyre
- Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France.,LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
| | - Keyne Charlot
- Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France.,LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
| | - Cyprien Bourrilhon
- Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France.,LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
| | - Julien Siracusa
- Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France.,LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
| | - Sebastian Garcia-Vicencio
- Unité de Physiologie de l'Exercice et des Activités en Conditions Extrêmes, Département Environnements Opérationnels, Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France.,LBEPS, Univ Evry, IRBA, Université Paris Saclay, Evry, France
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Hvedstrup J, Kolding LT, Ashina M, Schytz HW. Increased neck muscle stiffness in migraine patients with ictal neck pain: A shear wave elastography study. Cephalalgia 2020; 40:565-574. [DOI: 10.1177/0333102420919998] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BackgroundIctal neck pain is a frequent symptom reported by half of migraine patients. It is unknown if neck pain is caused by peripheral or central mechanisms. Neck muscle stiffness can be investigated with ultrasound shear wave elastography.ObjectivesTo determine if migraine patients with ictal neck pain have stiffer neck muscles interictally compared with patients without ictal neck pain and controls.MethodsThis was a cross-sectional study investigating neck muscle stiffness, pressure pain thresholds and neck pain symptoms in 100 migraine patients recruited from a tertiary headache center and 46 controls.ResultsPatients with ictal neck pain had increased mean neck muscle stiffness interictally compared to both migraine patients without ictal neck pain ( p = 0.018) and controls ( p = 0.036). Muscle stiffness was negatively correlated with pressure pain thresholds in the neck in migraine patients with ictal neck pain (r = −0.292, p = 0.042). There were no differences in mean pressure pain thresholds between migraine subgroups.ConclusionsMigraine patients with ictal neck pain have stiffer neck muscles interictally compared with migraine patients without ictal neck pain and controls measured with ultrasound shear wave elastography. The increased stiffness could be due to local alterations in the neck muscles. Trial registration: clinical-trials.gov, identifier: NCT03626805
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Affiliation(s)
- Jeppe Hvedstrup
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Lærke Tørring Kolding
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Henrik Winther Schytz
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
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Diagnosing Muscle Atrophy by Use of a Comprehensive Method of Assessing the Elastic Properties of Muscle During Passive Stretching. AJR Am J Roentgenol 2020; 214:862-870. [PMID: 31887095 DOI: 10.2214/ajr.19.21174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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81
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Taş S, Özkan Ö, Karaçoban L, Dönmez G, Çetin A, Korkusuz F. Knee muscle and tendon stiffness in professional soccer players: a shear-wave elastography study. J Sports Med Phys Fitness 2020; 60:276-281. [DOI: 10.23736/s0022-4707.19.09938-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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82
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Sun YM, Dong H, Du ZY, Yang ZL, Zhao C, Chong J, Li P. The effect of regions-of-interest and elasticity modulus selection on differentiating benign and malignant cervical lymph nodes with shear wave elastography. Clinics (Sao Paulo) 2020; 75:e1691. [PMID: 33146349 PMCID: PMC7561066 DOI: 10.6061/clinics/2020/e1691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/22/2020] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE Imaging diagnosis of cervical lymphadenopathy has conventionally used ultrasonography. Shear wave elastography (SWE) is a recent ultrasound technological advancement that has shown promise in the important medical problem of differentiating between benign and malignant cervical lymph nodes based on quantitative measurements of elasticity modulus. However, widely varying elasticity modulus metrics and regions-of-interest (ROIs) were used in existing studies, leading to inconsistent findings and results that are hard to compare with each other. METHODS Using a large dataset of 264 cervical lymph nodes from 200 patients, we designed a study comparing three elasticity modulus metrics (Emax, Emean, and standard deviation-SD) with three different ROIs to evaluate the effect of such selections. The metric values were compared between the benign and malignant node groups. The different ROI and metric selections were also compared through receiver operating characteristics curve analysis. RESULTS For all ROIs, all metric values were significantly different between the two groups, indicting their diagnostic potential. This was confirmed by the ≥0.80 area under the curve (AUC) values achieved with these metrics. Different ROIs had no effect on Emax, whereas all ROIs achieved high performance at 0.88 AUC. For Emean, the smallest ROI focusing on the area of the highest elasticity achieved the best diagnostic performance. In contrast, the larger ROIs achieved higher performances for SD. CONCLUSIONS This study illustrated the effect of elasticity modulus and ROI selection on the diagnostic performance of SWE on cervical lymphadenopathy. These new findings help guide relevant future studies and clinical applications of this important quantitative imaging modality.
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Affiliation(s)
- Yong-Mei Sun
- Department of Abdominal Ultrasound, the Affiliated Hospital of Qingdao University, No.16 Jiang Su Rd, Qingdao 266000, Shandong, China
| | - Hai Dong
- Department of Intensive Care Unit, the Affiliated Hospital of Qingdao University, No.16 Jiang Su Rd, Qingdao 266000, Shandong, China
- *Corresponding author. E-mail:
| | - Zong-Yan Du
- Department of Ultrasound, Maternity and Child Health Care of Zaozhuang, Xuecheng, Zaozhuang 277100, Shandong, China
| | - Zong-Li Yang
- Department of Abdominal Ultrasound, the Affiliated Hospital of Qingdao University, No.16 Jiang Su Rd, Qingdao 266000, Shandong, China
| | - Cheng Zhao
- Department of Abdominal Ultrasound, the Affiliated Hospital of Qingdao University, No.16 Jiang Su Rd, Qingdao 266000, Shandong, China
| | - Jing Chong
- Department of Abdominal Ultrasound, the Affiliated Hospital of Qingdao University, No.16 Jiang Su Rd, Qingdao 266000, Shandong, China
| | - Ping Li
- Department of Abdominal Ultrasound, the Affiliated Hospital of Qingdao University, No.16 Jiang Su Rd, Qingdao 266000, Shandong, China
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