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Zhou H, Shang H, Li X, Tian M, Wei R. Measuring healthy female nulliparous pubovisceral muscle from diffusion kurtosis imaging. NMR IN BIOMEDICINE 2022; 35:e4753. [PMID: 35485163 DOI: 10.1002/nbm.4753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 04/27/2022] [Accepted: 04/27/2022] [Indexed: 06/14/2023]
Abstract
This study explores the feasibility of using diffusion kurtosis imaging (DKI) in the pelvic floor region and assesses the water diffusivity of the pubovisceral muscle. Twenty-seven healthy young nulliparous females underwent DKI at 3.0 T that included 15 gradient directions and three b values (0, 750, and 1500 s/mm2 ). The diffusion tensor and diffusion kurtosis metrics values of the pubovisceral muscle were measured after image processing. Two independent sample t-tests, a paired-samples t-test, and a nonparametric hypothesis test were performed as appropriate to compare the differences among different metrics. Twenty-six subjects (mean ± standard deviation age, 25 ± 2 years) were successfully analyzed by measuring the diffusion tensor and diffusion kurtosis metrics of the bilateral pubovisceral muscles. The metrics included mean kurtosis, axial kurtosis, radial kurtosis, fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity. We found no statistically significant differences for these measurement values between the left and right pubovisceral muscles (p = 0.271-0.931). However, radial kurtosis was greater than axial kurtosis in both pubovisceral muscles (p < 0.001) and axial diffusivity was lower than radial diffusivity in both pubovisceral muscles (p < 0.001). We deem the application of DKI technology to the pelvic floor region to be feasible.
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Affiliation(s)
- Huiqing Zhou
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hua Shang
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaodong Li
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Miaomiao Tian
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Rongchen Wei
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Yu S, Su H, Lu J, Zhao F, Jiang F. Combined T2 Mapping and Diffusion Tensor Imaging: A Sensitive Tool to Assess Myofascial Trigger Points in a Rat Model. J Pain Res 2021; 14:1721-1731. [PMID: 34163230 PMCID: PMC8214538 DOI: 10.2147/jpr.s313966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background Myofascial trigger points (MTrPs) are defined as very small and hypersensitive points in skeletal muscle that are palpable, and produce localized pain on compression. The aim of this study was to explore the feasibility of combining T2 mapping with diffusion tensor imaging (DTI) for assessing MTrPs in a rat model and to investigate properties of the pathophysiological mechanisms. Methods Twenty-four Sprague-Dawley rats (model group, n = 14; control group, n = 10) underwent a magnetic resonance imaging (MRI) examination on a 3 T-MRI-scanner with a protocol consisting of T2 mapping and DTI. The MTrPs were established by blunt strike in combination with eccentric exercise. Enzyme-linked immunosorbent assays (ELISAs) were used to detect the levels of interleukin-1ß (IL-1ß) and interleukin-2 (IL-2) and their results were correlated with T2 values. Parameters from MRI including T2 values, fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD) were compared between the two groups. Histological analysis was applied to provide an additional supply for MRI findings. Results The MTrPs of rats displayed significantly increased T2 values and FA (= 0.000) compared with normal controls, whereas MD and RD values were significantly lower (P= 0.031, = 0.000, respectively). There was no statistically significant difference in AD between the two groups (P= 0.400). These differences were accompanied by elevated levels of IL-1ß and interleukin-2 IL-2 in the MTrP group compared with controls. T2 values were positively correlated with elevated IL-1ß levels (r = 0.543, P < 0.05) but were not correlated with IL-2 levels (P > 0.05). Conclusion Combining T2 and DTI sequences creates a sensitive tool to assess MTrPs in a rat model. These data clarify a hypothesis that a trigger point is a chronic and mild muscle injury with inflammation.
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Affiliation(s)
- Shuangcheng Yu
- Department of Radiology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530001, People's Republic of China
| | - Haiqing Su
- Department of Medical Ultrasound, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530001, People's Republic of China
| | - Jianchang Lu
- Department of Radiology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530001, People's Republic of China
| | - Fanyu Zhao
- Department of Radiology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530001, People's Republic of China
| | - Fangyan Jiang
- Department of Medical Ultrasound, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530001, People's Republic of China
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Evans V, Behr M, Gangwar A, Noseworthy MD, Kumbhare D. Potential Role of MRI Imaging for Myofascial Pain: A Scoping Review for the Clinicians and Theoretical Considerations. J Pain Res 2021; 14:1505-1514. [PMID: 34079365 PMCID: PMC8166277 DOI: 10.2147/jpr.s302683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/28/2021] [Indexed: 12/24/2022] Open
Abstract
The most common cause of chronic musculoskeletal pain is chronic myofascial pain syndrome (MPS). MPS often presents with increased muscle stiffness, and the myofascial trigger point (MTrP). Imaging modalities have been used to identify the MTrP, but their role in the detection and diagnosis of MPS remains unclear. The purpose of this review was to identify evidence in literature for the use of imaging in the role of classifying and explaining the physiology of MTrPs. Since few imaging techniques have been performed on MTrPs, we explored the imaging techniques that can effectively image complex skeletal muscle microstructure, and how they could be used. As part of a scoping review, we conducted a systematic search from three medical databases (CINAHL, EMBASE and MEDLINE) from year to year to analyze past MTrP imaging, as well as analyzing imaging techniques performed on the microstructure of muscle. Previously, ultrasound has been used to differentiate active, latent MTrPs, but these studies do not adequately address their underlying anatomical structure. MRI remains the standard method of imaging skeletal muscle. The existing MRI literature suggests that the DTI technique can quantify muscle injury, strain, and structure. However, theoretically, HARDI and DKI techniques seem to provide more information for complex structural areas, although these modalities have a disadvantage of longer scan times and have not been widely used on skeletal muscle. Our review suggests that DTI is the most effective imaging modality that has been used to define the microstructure of muscle and hence, could be optimal to image the MTrP. HARDI and DKI are techniques with theoretical potential for analysis of muscle, which may provide more detailed information representative of finer muscle structural features. Future research utilizing MRI techniques to image muscle are necessary to provide a more robust means of imaging skeletal muscle and the MTrP.
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Affiliation(s)
- Valerie Evans
- Institute of Biomaterials and Biomedical Engineering (IBBME), University of Toronto, Toronto, Ontario, Canada.,University Health Network - Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Michael Behr
- University Health Network - Toronto Rehabilitation Institute, Toronto, Ontario, Canada.,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
| | - Anshika Gangwar
- University Health Network - Toronto Rehabilitation Institute, Toronto, Ontario, Canada
| | - Michael D Noseworthy
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, Ontario, Canada
| | - Dinesh Kumbhare
- Institute of Biomaterials and Biomedical Engineering (IBBME), University of Toronto, Toronto, Ontario, Canada.,University Health Network - Toronto Rehabilitation Institute, Toronto, Ontario, Canada.,Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
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Lyu X, Gao Y, Liu Q, Zhao H, Zhou H, Pan S. Exercise-induced muscle damage: multi-parametric MRI quantitative assessment. BMC Musculoskelet Disord 2021; 22:239. [PMID: 33653313 PMCID: PMC7927395 DOI: 10.1186/s12891-021-04085-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 02/15/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND To explore the value of magnetic resonance quantitative analysis using diffusion tensor imaging, T2 mapping, and intravoxel incoherent motion in the evaluation of eccentric exercise-induced muscle damage and to compare the effects of various eccentric exercise modes at different time points in rats. METHODS A total of 174 Sprague-Dawley male rats were randomly divided into five groups: control, once-only exercise, continuous exercise, intermittent exercise, and once-fatigue exercise groups. Each experimental group was divided into seven time-subgroups: 0.5 h, 24 h, 48 h, 72 h, 96 h, 120 h and 168 h after exercise. The quadriceps femoris muscles were then scanned using magnetic resonance imaging. The apparent diffusion coefficient and fractional anisotropy values of diffusion tensor imaging, T2 values of T2 mapping, D and D* values of intravoxel incoherent motion and optical density values of desmin were measured. Associations among different eccentric exercise programmes, magnetic resonance imaging findings, and histopathological results were evaluated. Dunnett's test, two-way repeated measures analysis of variance, and Pearson correlation analysis were used for statistical analysis. RESULTS Diffusion tensor imaging showed that the number of muscle fibre bundles decreased to varying degrees with different time points and eccentric exercises. Apparent diffusion coefficient values of the exercise groups showed a trend that first increased and then decreased, the opposite of fractional anisotropy. The specimens in all eccentric exercise programmes showed high signal T2 values after exercise, the highest among which was in the once-fatigue exercise group. D and D* in the experimental groups were significantly higher than those in the control group at 0.5-48 h after exercise. The apparent diffusion coefficient, fractional anisotropy, T2, D and D* values correlated with the optical density values of desmin. CONCLUSIONS Diffusion tensor imaging, T2 mapping, and intravoxel incoherent motion technology accurately reflect the degree of skeletal muscle damage and recovery associated with eccentric exercise. The degree of muscle damage was the lowest in the continuous exercise group and the highest in the once-fatigue exercise group, which may provide more information and guidance for the formulation of physical and athletic training programmes.
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Affiliation(s)
- Xiaohong Lyu
- Department of Radiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, China.,Department of Radiology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121000, China
| | - Yue Gao
- Department of Radiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, China
| | - Qiang Liu
- Department of Radiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, China
| | - Heng Zhao
- Department of Radiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, China
| | - Huadong Zhou
- Department of Radiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, China
| | - Shinong Pan
- Department of Radiology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, China.
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Nakashima D, Fujita N, Hata J, Komaki Y, Suzuki S, Nagura T, Fujiyoshi K, Watanabe K, Tsuji T, Okano H, Jinzaki M, Matsumoto M, Nakamura M. Quantitative analysis of intervertebral disc degeneration using Q-space imaging in a rat model. J Orthop Res 2020; 38:2220-2229. [PMID: 32458477 DOI: 10.1002/jor.24757] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/17/2020] [Accepted: 05/25/2020] [Indexed: 02/04/2023]
Abstract
The degree of intervertebral disc (IVD) degeneration is qualitatively evaluated on T2-weighted imaging (T2WI). However, it is difficult to assess subtle changes in IVD degeneration using T2WI. Q-space imaging (QSI) is a quantitative diffusion-weighted imaging modality used to detect subtle changes in microenvironments. This study aimed to evaluate whether QSI can detect the inhibitory effects of the antioxidant N-acetylcysteine (NAC) in IVD degeneration. We classified female Wistar rats into control, puncture, and NAC groups (n = 5 per group). In the puncture and NAC groups, IVDs were punctured using a needle. The antioxidant NAC, which suppresses the progression of IVD degeneration, was orally administered in the NAC group 1 week prior to puncture. The progression and inhibitory effect of NAC in IVD degeneration were assessed using magnetic resonance imaging (MRI): IVD height, T2 mapping, apparent diffusion coefficient (ADC), and QSI. MRI was performed using a 7-Tesla system with a conventional probe (20 IVDs in each group). QSI parameters that were assessed included Kurtosis, the probability at zero displacement (ZDP), and full width at half maximum (FWHM). IVD degeneration by puncture was confirmed by histology, IVD height, T2 mapping, ADC, and all QSI parameters (P < .001); however, the inhibitory effect of NAC was confirmed only by QSI parameters (Kurtosis and ZDP: both P < .001; FWHM: P < .01). Kurtosis had the largest effect size (Kurtosis: 1.13, ZDP: 1.06, and FWHM: 1.02) when puncture and NAC groups were compared. QSI has a higher sensitivity than conventional quantitative methods for detecting the progressive change and inhibitory effect of NAC in IVD degeneration.
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Affiliation(s)
- Daisuke Nakashima
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Nobuyuki Fujita
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Department of Orthopaedic Surgery, Fujita Health University, Toyoake, Aichi, Japan
| | - Junichi Hata
- Division of Regenerative Medicine, Jikei University Graduate School of Medicine, Minato, Tokyo, Japan.,Department of Physiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Laboratory for Marmoset Neural Architecture, RIKEN Brain Science Institute, Wako, Saitama, Japan
| | - Yuji Komaki
- Department of Physiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Live Imaging Center, Central Institute for Experimental Animals, Kawasaki, Kanagawa, Japan
| | - Satoshi Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Department of Orthopaedic Surgery, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Chiba, Japan
| | - Takeo Nagura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Department of Clinical Biomechanics, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Kanehiro Fujiyoshi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Department of Orthopaedic Surgery, Murayama Medical Center, Murayama, Tokyo, Japan
| | - Kota Watanabe
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Takashi Tsuji
- Department of Orthopaedic Surgery, National Hospital Organization Tokyo Medical Center, Meguro, Tokyo, Japan
| | - Hideyuki Okano
- Department of Physiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.,Laboratory for Marmoset Neural Architecture, RIKEN Brain Science Institute, Wako, Saitama, Japan.,Live Imaging Center, Central Institute for Experimental Animals, Kawasaki, Kanagawa, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Noninvasive technique to evaluate the muscle fiber characteristics using q-space imaging. PLoS One 2019; 14:e0214805. [PMID: 30947237 PMCID: PMC6449066 DOI: 10.1371/journal.pone.0214805] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 03/20/2019] [Indexed: 01/23/2023] Open
Abstract
Background Skeletal muscles include fast and slow muscle fibers. The tibialis anterior muscle (TA) is mainly composed of fast muscle fibers, whereas the soleus muscle (SOL) is mainly composed of slow muscle fibers. However, a noninvasive approach for appropriately investigating the characteristics of muscles is not available. Monitoring of skeletal muscle characteristics can help in the evaluation of the effects of strength training and diseases on skeletal muscles. Purpose The present study aimed to determine whether q-space imaging can distinguish between TA and SOL in in vivo mice. Methods In vivo magnetic resonance imaging of the right calves of mice (n = 8) was performed using a 7-Tesla magnetic resonance imaging system with a cryogenic probe. TA and SOL were assessed. q-space imaging was performed with a field of view of 10 mm × 10 mm, matrix of 48 × 48, and section thickness of 1000 μm. There were ten b-values ranging from 0 to 4244 s/mm2, and each b-value had diffusion encoding in three directions. Magnetic resonance imaging findings were compared with immunohistological findings. Results Full width at half maximum and Kurtosis maps of q-space imaging showed signal intensities consistent with immunohistological findings for both fast (myosin heavy chain II) and slow (myosin heavy chain I) muscle fibers. With regard to quantification, both full width at half maximum and Kurtosis could represent the immunohistological findings that the cell diameter of TA was larger than that of SOL (P < 0.01). Conclusion q-space imaging could clearly differentiate TA from SOL using differences in cell diameters. This technique is a promising method to noninvasively estimate the fiber type ratio in skeletal muscles, and it can be further developed as an indicator of muscle characteristics.
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