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Fu C, Xia Y, Wang B, Zeng Q, Pan S. MRI T2 mapping and shear wave elastography for identifying main pain generator in delayed-onset muscle soreness: muscle or fascia? Insights Imaging 2024; 15:67. [PMID: 38424366 PMCID: PMC10904698 DOI: 10.1186/s13244-024-01619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/06/2023] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION The main generator of delayed onset muscle soreness (DOMS) is still unknown. This study aimed to clarify the main generator of DOMS. METHODS Twelve participants performed eccentric exercise (EE) on lower legs. MRI and ultrasound were used to assess changes of calf muscle and deep fascia before and after EE. These results were then compared to the muscle pain level. RESULTS Compared to baseline, muscle pain peaked at 24-48 h after EE (downstairs 22.25 ± 6.196, 57.917 ± 9.298, F = 291.168, p < 0.01; resting 5.833 ± 1.899, 5.083 ± 2.429, F = 51.678, p < 0.01). Shear wave speed (SWE) of the deep fascia and T2 values of the gastrocnemius muscle and deep fascia all increased and peaked at 48 h after EE (1.960 ± 0.130, F = 22.293; 50.237 ± 2.963, F = 73.172; 66.328 ± 2.968, F = 231.719, respectively, p < 0.01). These measurements were positively correlated with DOMS (downstairs: r = 0.46, 0.76, 0.87, respectively, p < 0.001; resting: r = 0.42, 0.70, 0.77, respectively, p < 0.001). There was a significant positive correlation between SWE and T2 values of deep fascia (r = 0.54, p < 0.01). CONCLUSION DOMS is a common result of muscle and fascia injuries. Deep fascia edema and stiffness play a crucial role in DOMS, which can be effectively evaluated MR-T2 and SWE. CRITICAL RELEVANCE STATEMENT Delayed-onset muscle soreness is a common result of muscle and deep fascia injuries, in which the edema and stiffness of the deep fascia play a crucial role. Both MRI and shear wave elastography can be effectively used to evaluate soft tissue injuries. KEY POINTS • The deep fascia is the major pain generator of delayed-onset muscle soreness. • There is a significant correlation between fascia injury and delayed-onset muscle soreness. • MRI and shear wave elastography are preferred methods for assessing fascia injuries.
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Affiliation(s)
- Congcong Fu
- Department of Magnetic Resonance Imaging, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, China
| | - Yu Xia
- Department of Medical Ultrasonic, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, China
| | - Bingshan Wang
- Department of Magnetic Resonance Imaging, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, China
| | - Qiang Zeng
- Department of Magnetic Resonance Imaging, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, China.
| | - Shinong Pan
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
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Lubin P, Zidi M. Mechanical properties change of immobilized skeletal muscle in short position measured by shear wave elastography and pure shearing test. J Mech Behav Biomed Mater 2024; 150:106317. [PMID: 38118374 DOI: 10.1016/j.jmbbm.2023.106317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/26/2023] [Accepted: 12/10/2023] [Indexed: 12/22/2023]
Abstract
The purpose of this study was to evaluate the effects of immobilization on mechanical properties of skeletal muscle over the time. An in vivo rat model was used to investigate the shear modulus change of the flexor carpi ulnaris (FCU) in a short position. Measurements were performed by shear wave elastography (SWE) to compare contralateral and immobilized cases. The results showed a significant increase of 18.1% (p = 3.86. 10-7) in the shear modulus of immobilized skeletal muscle after two weeks (D14) when compared with the contralateral case. For the purposes of comparison, in vitro mechanical pure shearing tests were performed on samples collected from the skeletal muscles of the same rats. Although the difference between contralateral and immobilized cases was 17.6% (p = 0.32) at D14, the shear modulus difference was 35.7% (p = 0.0126 and p = 1.57.10-5 for immobilization and contralateral respectively) between in vivo and in vitro approaches. The mechanical properties changes were then correlated with the density of collagen from histological analysis, and it was shown that the contralateral collagen surface density was 25.4% higher than the immobilized density at D14 (p = 0.001). Thus, the results showed the feasibility of the comparison between the two approaches, which can surely be improved by optimizing the experimental protocols.
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Affiliation(s)
- Pénélope Lubin
- Bioengineering, Tissues and Neuroplasticity, UR 7377, Université Paris-Est Créteil, Faculté de Santé /EPISEN, 8 rue du Général Sarrail, 94010, Créteil, France
| | - Mustapha Zidi
- Bioengineering, Tissues and Neuroplasticity, UR 7377, Université Paris-Est Créteil, Faculté de Santé /EPISEN, 8 rue du Général Sarrail, 94010, Créteil, France.
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Kobayashi T, Hirota K, Otsuki R, Onodera J, Kodesho T, Taniguchi K. Morphological and mechanical characteristics of the intrinsic and extrinsic foot muscles under loading in individuals with flat feet. Gait Posture 2024; 108:15-21. [PMID: 37976604 DOI: 10.1016/j.gaitpost.2023.11.001] [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: 03/19/2023] [Revised: 10/04/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND The intrinsic and extrinsic foot softtissue structures that apply force and support the medial longitudinal arch (MLA) have been implicated in the development of flat feet. However, the relationship between the changes in MLA height under increasing load and the morphological and mechanical properties of individual intrinsic and extrinsic foot soft tissue structures is not fully understood. RESEARCH QUESTION To examine the morphological and mechanical characteristics of the foot soft tissue structures in flat feet when subjected to loading. METHODS This study consisted of two studies focusing on the extrinsic foot muscles (10 normal feet/11 flat feet) and intrinsic foot muscles (14 normal feet/13 flat feet). Images of the extrinsic and intrinsic foot muscles and plantar fascia (PF) under 10%, 50%, and 90% body weight conditions were obtained using ultrasound-based shear-wave elastography. RESULTS The cross-sectional area (CSA) of the peroneus brevis was larger in the flat-foot group than in the normal-foot group under all loading conditions. The CSAs of the intrinsic foot muscles (abductor hallucis, flexor digitorum brevis, and quadratus plantae) and thickness of the PF in the flat-foot group decreased significantly with increasing load. As for mechanical characteristics, the stiffness of the flexor digitorum longus and abductor hallucis was higher in the flat-foot group than in the normal group under high loading conditions. In addition, flat feet with greater flexibility tended to exhibit a greater decrease in PF thickness and smaller increase in stiffness. SIGNIFICANCE Excessive stretching of the intrinsic foot muscles and PF occurs in flat feet, and excessive contraction of the flexor digitorum longus may counteract the excessive lowering of the foot arch. Therefore, it is necessary to promote the contraction of the intrinsic foot musculature in feet with greater flexibility of the MLA during loading.
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Affiliation(s)
- Takumi Kobayashi
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan; Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan.
| | - Kento Hirota
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan; Tokachi Physical Lab, Obihiro, Japan
| | - Ryo Otsuki
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan
| | - Juri Onodera
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, Chitose, Japan
| | - Taiki Kodesho
- Department of Sport Science and Research, Japan Institute of Sports Sciences (JISS), Tokyo, Japan
| | - Keigo Taniguchi
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
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Shembel AC, Morrison RA, Fetzer DT, Patterson-Lachowicz A, McDowell S, Comstock Smeltzer JC, Mau T. Extrinsic Laryngeal Muscle Tension in Primary Muscle Tension Dysphonia with Shear Wave Elastography. Laryngoscope 2023; 133:3482-3491. [PMID: 37334857 PMCID: PMC10728340 DOI: 10.1002/lary.30830] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES It has been assumed that patients with primary muscle tension dysphonia (pMTD) have more extrinsic laryngeal muscle (ELM) tension, but tools to study this phenomenon lack. Shear wave elastography (SWE) is a potential method to address these shortcomings. The objectives of this study were to apply SWE to the ELMs, compare SWE measures to standard clinical metrics, and determine group differences in pMTD and typical voice users before and after vocal load. METHODS SWE measurements of the ELMs from ultrasound examinations of the anterior neck, supraglottic compression severities from laryngoscopic images, cepstral peak prominences (CPP) from voice recordings, and self-perceptual ratings of vocal effort and discomfort were obtained in voice users with (N = 30) and without (N = 35) pMTD, before and after a vocal load challenge. RESULTS ELM tension significantly increased from rest-to-voiced conditions in both groups. However, the groups were similar in their ELM stiffness levels at SWE at baseline, during vocalization, and post-vocal load. Levels of vocal effort and discomfort and supraglottic compression were significantly higher and CPP was significantly lower in the pMTD group. Vocal load had a significant effect on vocal effort and discomfort but not on laryngeal or acoustic patterns. CONCLUSION SWE can be used to quantify ELM tension with voicing. Although the pMTD group reported significantly higher levels of vocal effort and vocal tract discomfort and, on average, exhibited significantly more severe supraglottic compression and lower CPP values, there were no group differences in levels of ELM tension using SWE. LEVEL OF EVIDENCE 2 Laryngoscope, 133:3482-3491, 2023.
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Affiliation(s)
- Adrianna C. Shembel
- Department of Otolaryngology-Head and Neck, Voice Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - Robert A. Morrison
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - David T. Fetzer
- Department of Radiology, CACTUS Lab, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Amber Patterson-Lachowicz
- Department of Radiology, CACTUS Lab, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Sarah McDowell
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - Julianna C. Comstock Smeltzer
- School of Behavioral and Brain Sciences, Department of Speech, Language, and Hearing, University of Texas at Dallas, Richardson, TX, United States
| | - Ted Mau
- Department of Otolaryngology-Head and Neck, Voice Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
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Kobayashi T, Kodesho T, Kinami K, Takahashi A, Taniguchi K, Taniguchi K. Characteristics of the static muscle stiffness of ankle plantar flexors in individuals with chronic ankle instability. J Med Ultrason (2001) 2023; 50:561-570. [PMID: 37640966 DOI: 10.1007/s10396-023-01360-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/07/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Individuals with chronic ankle instability (CAI) have deficits in closed kinetic chain dorsiflexion that may perpetuate injury. Determining the characteristics of muscle stiffness in the plantar flexors of individuals with CAI may help in developing appropriate treatments. We aimed to highlight the characteristics of static muscle stiffness in ankle plantar flexor muscles during the passive dorsiflexion of the ankle joint in individuals with CAI. METHODS A total of 30 patients were included in the study based on the International Ankle Consortium criteria. The patients were categorized evenly into healthy, coper, and CAI groups (i.e., 10 patients in each group). After measuring the dorsiflexion range of motion (non-weight-bearing/weight-bearing) of the ankle joint, the static muscle stiffness measurements of the medial gastrocnemius, lateral gastrocnemius, soleus, and peroneus longus were obtained. The measurements were performed during the knee joint's extension and 50° flexion and passive dorsiflexion between the range of 40° plantar flexion and 20° dorsiflexion. RESULTS The dorsiflexion range of motion of the CAI group was significantly smaller than that of the healthy and coper groups in the weight-bearing position. No interaction was observed for muscle stiffness in both the knee flexion and extension positions, and no significant differences were identified among the three groups. The shear modulus of the soleus at 20° ankle dorsiflexion with knee flexion had a significant negative correlation with the weight-bearing range of motion of the ankle. CONCLUSION The limitation in the weight-bearing dorsiflexion range of motion in CAI was largely due to factors other than the increased elasticity of the ankle plantar flexor muscles.
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Affiliation(s)
- Takumi Kobayashi
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan.
| | - Taiki Kodesho
- Department of Sport Science and Research, Japan Institute of Sports Sciences (JISS), Tokyo, Japan
| | - Keita Kinami
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan
| | - Ayuka Takahashi
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan
| | - Konatsu Taniguchi
- Department of Rehabilitation, Faculty of Health Science, Hokkaido Chitose College of Rehabilitation, 2-10 Satomi, Chitose, Hokkaido, 066-0055, Japan
| | - Keigo Taniguchi
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
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Nakao G, Kodesho T, Kato T, Yokoyama Y, Saito Y, Ohsaki Y, Watanabe K, Katayose M, Taniguchi K. Relationship between shear elastic modulus and passive muscle force in human hamstring muscles using a Thiel soft-embalmed cadaver. J Med Ultrason (2001) 2023; 50:275-283. [PMID: 37170041 PMCID: PMC10954965 DOI: 10.1007/s10396-023-01317-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/12/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE Assessing muscle flexibility and architecture is important for hamstring strain injury (HSI) prevention. We investigated the relationship between shear modulus and passive force in hamstring muscles at different sites and the effect of muscle architecture on the slope of the shear modulus-passive force using shear wave elastography (SWE). METHODS The biceps femoris long head (BFlh), semitendinosus (ST), and semimembranosus (SM) muscles were dissected from nine Thiel-embalmed cadavers and fixed to a custom-made mechanical testing machine. Calibrated weights (0-1800 g) were applied gradually in 150-g increments. The shear modulus and anatomical cross-sectional area (ACSA) were measured at proximal, central, and distal points using SWE. The muscle mass and length were measured before the loading test. The shear modulus-passive load relationship of each tested muscle region was analyzed by fitting a least-squares regression line. The increase in shear modulus slope per unit load was calculated and compared between the muscles before and after normalization by the muscle mass, length, and ACSA. RESULTS The shear modulus and passive force for all hamstring muscles in each region showed a statistically significant linear correlation. Furthermore, the increase in shear modulus slope was greater for BFlh and ST than for SM (P < 0.05), but after normalization by the muscle length and ACSA, there were no significant differences among the muscles. CONCLUSION The local mechanical properties of individual hamstring muscles can be indirectly estimated using SWE, and the slope of increase in shear modulus reflects characteristics of the muscle architecture.
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Affiliation(s)
- Gakuto Nakao
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
- Professional Post-Secondary Course (Physical Therapist), Sapporo Medical Technology, Welfare and Dentistry Professional Training College of Nishino Gakuen School Foundation, Sapporo, Japan
| | - Taiki Kodesho
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Takuya Kato
- Department of Rehabilitation, Hitsujigaoka Hospital, Sapporo, Japan
| | - Yu Yokoyama
- Department of Rehabilitation, Heiseikai Hospital, Sapporo, Japan
| | - Yuhei Saito
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Yuki Ohsaki
- First Division of Anatomy, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Kota Watanabe
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, South-1, West-17, Chuo-Ku, Sapporo, Hokkaido, 060-8556, Japan
| | - Masaki Katayose
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, South-1, West-17, Chuo-Ku, Sapporo, Hokkaido, 060-8556, Japan
| | - Keigo Taniguchi
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, South-1, West-17, Chuo-Ku, Sapporo, Hokkaido, 060-8556, Japan.
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Kato T, Taniguchi K, Kodesho T, Nakao G, Yokoyama Y, Saito Y, Katayose M. Quantifying the shear modulus of the adductor longus muscle during hip joint motion using shear wave elastography. Sci Rep 2023; 13:9510. [PMID: 37308569 DOI: 10.1038/s41598-023-36698-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/08/2023] [Indexed: 06/14/2023] Open
Abstract
The present study aims to assess the effect of the hip flexion angle on the shear modulus of the adductor longus (AL) muscle associated with passive hip abduction and rotation. Sixteen men participated in the study. For the hip abduction task, the hip flexion angles used were - 20, 0, 20, 40, 60, and 80°, and the hip abduction angles were 0, 10, 20, 30, and 40°. For the hip rotation task, the hip flexion angles used were - 20, 0, 20, 40, 60, and 80°, hip abduction angles were 0 and 40°, and hip rotation angles were 20° internal rotation, 0° rotation, and 20° external rotation. The shear modulus at 20° extension was significantly higher than that at 80° flexion for the 10, 20, 30 and 40° hip abduction (i.e., P < 0.05). The shear modulus at 20° internal rotation and 20° extension was significantly higher than that at 0° rotation and 20° external rotation, regardless of the hip abduction angle (i.e., P < 0.05). The mechanical stress of the AL muscle associated with hip abduction was higher in the extended position. Furthermore, the mechanical stress could increase with internal rotation only at the hip-extended position.
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Affiliation(s)
- Takuya Kato
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
- Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Keigo Taniguchi
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan.
| | - Taiki Kodesho
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Gakuto Nakao
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Yu Yokoyama
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Yuhei Saito
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Masaki Katayose
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
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Yi J, Cha JG, Hahn S. Comparison of shear wave elastography with gray-scale USG and CT for quantitative evaluation of rectus femoris muscle. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:703-710. [PMID: 36710597 DOI: 10.1002/jcu.23435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE The purpose of this study was to compare the measurement of shear wave elastography (SWE) and gray scale ultrasonography (GSU) and CT attenuation of mid-rectus femoris (RF) muscle in healthy adults. METHODS This prospective study included 70 participants with a healthy body mass index (<25 kg/m2 ) between June 2019 and January 2020. Echo intensity (EI) grading of RF on GSU was performed. SWE was performed for the three levels of the RF. Measurements were repeated 10 min after the first measurement. The mid-RF attenuation on CT was also measured. Interobserver agreement of EI grade among three readers was assessed using weighted-kappa statistics. The reliability of SWE was assessed using intraclass correlation coefficient. The correlations between the SWE and CT/GSU measurements were analyzed. RESULTS Interobserver agreement of EI grade on GSU by the three radiologists was moderate to substantial (k = 0.562-0.767). The inter-session agreements for SWE were almost perfect for mid RF (k = 0.822-0.829) and substantial for proximal and distal RF (k = 0.767-0.795). There were significant correlations between SWE-EI and SWE-CT attenuation (p < 0.001, respectively) at the mid-RF. CONCLUSIONS SWE measurements on mid-RF demonstrated the highest reliability. SWE parameters showed a strong correlation with EI on GSU and attenuation on CT.
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Affiliation(s)
- Jisook Yi
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Jang Gyu Cha
- Department of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, South Korea
| | - Seok Hahn
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
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Deng M, Zhou L, Chen Z, Yuan G, Zhou Y, Xiao Y. An ex-vivo validation of the modulus-length framework to characterize passive elastic properties of skeletal muscle. ULTRASONICS 2023; 129:106904. [PMID: 36463727 DOI: 10.1016/j.ultras.2022.106904] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 09/09/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
The passive elastic properties of skeletal muscles are related closely to muscle extensibility and flexibility. Recently, a single probe setup has been reported that measures the passive elastic properties of muscles in vivo. This uses a modulus-length framework to investigate sensitive dynamic parameters, termed as passive elastic coefficient k, slack length l0, and slack shear modulus G0 to quantify the passive elastic properties of human muscle. In particular, the parameter k calculated based on this framework reflects the change rate of the local shear modulus with respect to the muscle length, which remains constant during the entire passive stretching process. In this report, the modulus-length framework was validated in four groups of ex-vivo muscle samples (young and old chickens, pork, and beef). All the muscle samples were stretched mechanically whilst muscle length was monitored and recorded with simultaneous measurement of dynamic shear wave elastography (SWE). Agreement analyses using Bland-Altman diagrams and intraclass correlation coefficients (ICC) were then performed on coefficient k values obtained by mechanical stretching (k1) and real-time ultrasound imaging methods (k2). Bland-Altman diagrams show that the majority of the points lie within the 95 % LoA ([-1.87, 2.29]; p = 0.276) and the level of reliability was "good" to "excellent" based on the ICC results (ICC, 0.904; 95 % confidence interval, 0.813-0.953). This indicated that the ultrasound and mechanical methods produced very similar results. Meanwhile, the range of the coefficient k values in four muscle types and groups was significantly different (p < 0.05), a finding which strongly supports the potential use of this coefficient to characterize muscle quality and status.
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Affiliation(s)
- Miaoqin Deng
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China; Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Liying Zhou
- Department of Obstetrics and Gynecology, Shenzhen Longhua District Central Hospital, Guangdong Medical University Affiliated Longhua District Central Hospital, Shenzhen, China
| | - Zengtong Chen
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Guojian Yuan
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Yongjin Zhou
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China; Marshall Laboratory of Biomedical Engineering, Shenzhen University, Shenzhen, China
| | - Yang Xiao
- National Innovation Center For Advanced Medical Devices, Shenzhen National Research Institute of High Performance Medical Devices Co, Ltd, Shenzhen, China
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Wei HQ, Gan M, Li GY, Ma SH, Liu JH. Quantitative Evaluation of Biceps Brachii Muscle by Shear Wave Elastography in Stroke Patients. Ther Clin Risk Manag 2022; 18:879-887. [PMID: 36212049 PMCID: PMC9541677 DOI: 10.2147/tcrm.s361664] [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: 02/09/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The present study aimed to investigate the differences in muscle size and shear wave speed (SWS) values of biceps brachii muscle (BBM) between stroke survivors and healthy controls. Methods This study comprised 61 stroke survivors and 24 healthy subjects, examined at Guangzhou First People's Hospital within one year. Each participant underwent ultrasonic examinations for recording some specific measurement indicators, including muscle thickness, cross-sectional area (CSA), and shear wave speed (SWS) of BBM. The muscular tension of the paretic arm was scored using the modified Ashworth scale (MAS). These above-mentioned indexes were compared between stroke survivors and healthy controls. Also, the correlations among SWS and MAS scores were assessed. Results When the lifting arm angle was set for 45°, the CSA and muscle thickness of BBM were obviously decreased in the paretic arms of stroke subjects compared to the non-paretic arms as well as the arms of healthy controls. Moreover, the paretic arms had obviously higher SWS than the non-paretic arms and the healthy arms at 45° or 90°. When the angles of paretic arms were lifted at 90° and 45°, respectively, a positive correlation was established between MAS and SWS. Conclusion Ultrasonic examination assessing muscle thickness, CSA, and SWS of the BBM could be used as a means of assessment of the paretic arms of stroke survivors.
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Affiliation(s)
- Hong-Qin Wei
- Department of Ultrasound, Guangzhou First People’s Hospital, Guangzhou, Guandong, People’s Republic of China
| | - Man Gan
- Department of Ultrasound, Guangzhou First People’s Hospital, Guangzhou, Guandong, People’s Republic of China
| | - Guo-Yan Li
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, Guangzhou, Guandong, People’s Republic of China
| | - Sui-Hong Ma
- Department of Ultrasound, Guangzhou First People’s Hospital, Guangzhou, Guandong, People’s Republic of China,Correspondence: Sui-Hong Ma; Jian-Hua Liu, Tel +86 13824420620; +86 13622888381, Fax +86 020 81332620, Email ;
| | - Jian-Hua Liu
- Department of Ultrasound, Guangzhou First People’s Hospital, Guangzhou, Guandong, People’s Republic of China
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Kato T, Taniguchi K, Kodesho T, Nakao G, Yokoyama Y, Saito Y, Katayose M. Adductor longus: An anatomical study to better understand groin pain. Clin Anat 2022; 35:867-872. [PMID: 35393703 DOI: 10.1002/ca.23881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION We investigated the shear modulus-passive force relationship in the hip adductor longus (AL) muscles of human cadavers and explored the effect of muscle architecture on the elastic properties of the AL muscle using shear wave elastography (SWE). MATERIALS AND METHODS Nine AL muscles were harvested from a soft, embalmed cadaver. The AL muscles were affixed to a custom-built device comprising two clamps, a pulley, and a cable to provide passive loads, which were increased from 0 to 600 g in 60-g increments. The shear modulus of the AL muscle was measured in the proximal (Pro), middle (Mid), and distal (Dis) regions. The masses and anatomical cross-sectional areas (ACSAs) of the AL muscles were measured. The shear modulus-passive load relationship of each tested muscle region was analyzed by fitting a least-squares regression line. Moreover, the rate of increase in the shear modulus per unit load (s) was calculated. RESULTS The shear modulus and passive force were linearly correlated for all AL muscles in each region (P<0.01). The mean coefficients of determination (R2 ) for Pro, Mid, and Dis were 0.989, 0.986, and 0.982, respectively. The rate of increase in the shear modulus per unit load significantly correlated with the reciprocal of the muscle mass (r=0.77, P=0.02) and ACSA (r=0.43, P=0.03). CONCLUSION Shear wave elastography can be used as an indirect measure of passive force in any region of the AL muscle. Additionally, the rate of increase in the shear modulus per unit load could be associated with muscle architectural parameters. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Takuya Kato
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Keigo Taniguchi
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Taiki Kodesho
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Gakuto Nakao
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Yu Yokoyama
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Yuhei Saito
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Masaki Katayose
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
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12
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Yu HK, Liu X, Pan M, Chen JW, Liu C, Wu Y, Li ZB, Wang HY. Performance of Passive Muscle Stiffness in Diagnosis and Assessment of Disease Progression in Duchenne Muscular Dystrophy. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:414-421. [PMID: 34893358 DOI: 10.1016/j.ultrasmedbio.2021.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/07/2021] [Accepted: 09/02/2021] [Indexed: 06/14/2023]
Abstract
The aim of this study was to evaluate the performance of passive muscle stiffness in diagnosing and assessing disease progression in Duchenne muscular dystrophy (DMD). Boys with DMD and age-matched controls were recruited. Shear wave elastography (SWE) videos were collected by performing dynamic stretching of the gastrocnemius medius (GM). At ankle angles from plantar flexion (PF) 30° to dorsiflexion (DF) 20°, the shear modulus of the GM was measured for each 10° of ankle movement. Shear modulus at each ankle angle was compared between the DMD and control group. Correlation between passive muscle stiffness and motor function grading was also analyzed. A total of 26 patients with DMD and 20 healthy boys were enrolled. At multiple stretch levels, passive muscle stiffness of the GM was significantly higher in patients with DMD than in those in the control group (all p values <0.05). The shear modulus of GM at an ankle angle of DF 10° had the largest area under the receiver operating characteristic curve in differentiating DMD patients from normal subjects (AUC = 0.902, 95% confidence interval: 0.814-0.990). Motor function grading was a significant determinant of passive muscle stiffness at an ankle angle of DF 10° (B = 21.409, t = 3.372, p = 0.003). Passive muscle stiffness may potentially serve as a useful non-invasive tool to monitor disease progression in DMD patients.
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Affiliation(s)
- Hong-Kui Yu
- Department of Ultrasonography, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiao Liu
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Fu-tian), Shenzhen, Guangdong, China
| | - Min Pan
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Fu-tian), Shenzhen, Guangdong, China
| | - Jin-Wei Chen
- Department of Ultrasonography, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Chen Liu
- Department of Ultrasonography, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yu Wu
- Department of Radiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhi-Bin Li
- Department of Rehabilitation, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hong-Ying Wang
- Department of Ultrasonography, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China.
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13
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Cao J, Xiao Y, Qiu W, Zhang Y, Dou Z, Ren J, Zheng R, Zheng H, Chen Z. Reliability and diagnostic accuracy of corrected slack angle derived from 2D-SWE in quantitating muscle spasticity of stroke patients. J Neuroeng Rehabil 2022; 19:15. [PMID: 35120556 PMCID: PMC8817514 DOI: 10.1186/s12984-022-00995-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 01/25/2022] [Indexed: 12/21/2022] Open
Abstract
Background To explore the feasibility of corrected slack angle acquired from two-dimensional shear wave elastography (2D-SWE) for quantitating the spasticity of medial gastrocnemius (MG) in stroke patients. Methods Consecutive stroke patients with spastic MG and matched healthy controls were recruited. Intra- and interobserver reliability of 2D-SWE measurement were evaluated, and the correlation between corrected slack angle and modified Ashworth scale (MAS) score was examined. The corrected slack angle before and after botulinum toxin A (BoNT-A) injection was compared and its diagnostic performance in classifying the severity of spasticity were assessed with receiver operating characteristic (ROC) curve analysis. Results The intra- (0.791 95% CI 0.432–0.932) and interobserver (0.751 95% CI 0.382–0.916) reliability of slack angle acquired with 2D-SWE were good. Significant correlation was found between corrected slack angle and MAS score (R = − 0.849, p < 0.001). The corrected slack angle increased after BoNT-A injection. The cutoff value of MAS ≥ 3 had the highest sensitivity (100%) and specificity (93.33%). The positive predictive value (PPV) for classification of MAS ≥ 1+ and the negative predictive value (NPV) for classification of MAS ≥ 3 were greater than 90%. Conclusion 2D-SWE was a reliable method to quantitate the post-stroke spasticity. The corrected slack angle had advantage in classifying the severity of spasticity, especially in early identification of mild spasticity and confirmation of severe spasticity. Supplementary Information The online version contains supplementary material available at 10.1186/s12984-022-00995-8.
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Affiliation(s)
- Junyan Cao
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China
| | - Yang Xiao
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen, 518055, China
| | - Weihong Qiu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China
| | - Yanling Zhang
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China
| | - Zulin Dou
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China
| | - Jie Ren
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China
| | - Rongqin Zheng
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen, 518055, China
| | - Zhaocong Chen
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China.
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14
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Şendur HN, Cerit MN, Şendur AB, Özhan Oktar S, Yücel C. Evaluation of Diaphragm Thickness and Stiffness Using Ultrasound and Shear-Wave Elastography. Ultrasound Q 2022; 38:89-93. [PMID: 35001026 DOI: 10.1097/ruq.0000000000000593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ABSTRACT The purposes of this study are to measure the thickness and stiffness of diaphragm in association with the respiratory cyclus and to assess the reproducibility of these measurements. Forty individuals who are volunteered for participating diaphragm evaluation were included in the study. Two radiologists with 14 and 15 years of experiences in abdominal ultrasound performed all examinations independently. Furthermore, 8 chronic obstructive pulmonary disease (COPD) patients were examined by only the first radiologist. Gray scale and shear-wave elastography imaging of only the right hemidiaphragm of all participants were performed. Thickness and stiffness of diaphragm were measured at the peak inspiration and end expiration phases. Intraclass correlation coefficients test was used to assess the interobserver agreement. The thickness and stiffness of diaphragm significantly increased with inspiration (P < 0.001). The mean ± SD stiffness of diaphragm in peak inspiration and end expiration phases was 51.84 ± 16.83 kPa and 38.49 ± 9.42 kPa, respectively, for the first radiologist and 49.61 ± 13.83 kPa and 37.52 ± 10.71 kPa, respectively, for the second radiologist. Intraclass correlation coefficient values for diaphragm stiffness were 0.667 and 0.736 in peak inspiration and end expiration phases, respectively. In COPD patients, there was no significant difference between stiffness measurements of respiratory phases. In conclusion, the current study revealed that diaphragm thickness and stiffness increase at inspiration, and these measurements are slightly more reproducible at the end of expiration. However, diaphragm stiffness changes between respiratory phases may not be valid for COPD patients, and this may be related to loss of force-generating capacity of diaphragm in COPD patients.
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Affiliation(s)
| | - Mahi Nur Cerit
- Department of Radiology, Gazi University Faculty of Medicine
| | | | | | - Cem Yücel
- Department of Radiology, Gazi University Faculty of Medicine
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15
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Xiao Y, Wang C, Pan M, Chen Z, Ma T, Zhou Y, Liu X. Ultrasonic characterization of localized passive elastic properties of human pennate muscle with a single-probe setup. ULTRASONICS 2021; 116:106512. [PMID: 34274743 DOI: 10.1016/j.ultras.2021.106512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 06/09/2021] [Accepted: 06/30/2021] [Indexed: 06/13/2023]
Abstract
Quantitative evaluation of passive elastic properties of an individual skeletal muscle in vivo is among the major challenges of biomechanics, and its clinical application is severely limited. By combining shear-wave elastography (SWE) and B-mode imaging techniques, this study develops a novel non-invasive method to measure the local elastic modulus-fascicle strain curve of human pennation muscle during passive stretching using a single probe. Physiologically meaningful parameters are estimated and compared in subjects with different ages or pathological conditions. The in vivo experimental group comprised 12 healthy subjects (four children, four adults, and four seniors) and eight patients (four suffering from pseudohypertrophy, four from atrophy). Their gastrocnemius muscles were passively stretched using an ankle joint motion instrument. Local elastic moduli of the muscle were measured using SWE imaging frames and a built-in 'F-ROI' tool. The corresponding fascicle strains were simultaneously obtained using B-mode imaging frames and a gradient Radon transform. Three parameters (η, μ, G0) were estimated from a normalized elastic modulus-strain curve using the Gauss-Newton method. The measured elastic modulus-strain curves all agreed with models of the estimated parameters (0.910 < R2 < 0.999) and presented different patterns among normal and diseased subjects. η values were lower for pseudohypertrophies (1.93 ± 0.12), but higher for atrophies (63.40 ± 98.89), compared with normal ones (6.02 ± 2.53). In addition, μ values were higher for pseudohypertrophies (22.65 ± 16.40), but lower for atrophies (0.28 ± 0.41), compared with normal ones (1.07 ± 1.22). The proposed method may provide novel insight into the biomechanics of pennate muscle and has the potential to serve for clinical musculoskeletal medical diagnosis, as the single-probe scanning setup is broadly accepted.
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Affiliation(s)
- Yang Xiao
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Congzhi Wang
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Min Pan
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen 518034, China
| | - Zengtong Chen
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen 518055, China; Marshall Laboratory of Biomedical Engineering, China
| | - Teng Ma
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Yongjin Zhou
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen 518055, China; Marshall Laboratory of Biomedical Engineering, China
| | - Xiao Liu
- Department of Ultrasonography, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen 518034, China
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16
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Kolb M, Peisen F, Ekert K, Xenitidis T, Fritz J, Ioanoviciu SD, Henes J, Horger M. Shear Wave Elastography for Assessment of Muscular Abnormalities Related to Systemic Sclerosis. Acad Radiol 2021; 28:1118-1124. [PMID: 32527706 DOI: 10.1016/j.acra.2020.04.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 12/16/2022]
Abstract
RATIONALE AND OBJECTIVES To assess muscular abnormalities related to systemic sclerosis (SSc) using shear wave elastography and correlate results with those of clinical tests. MATERIALS AND METHODS We evaluated 55 patients (mean age: 50.4 years; range: 18-88; 34 female) with SSc before treatment and choose muscle groups based on cutaneous involvement and functional impairment [forearms (9); thighs (41); thenar/hypothenar (5)]. We performed shear wave elastography in two orientations to access heterogeneity using virtual touch IQ and mean shear wave velocity values (SWV) and measured skin and fascia thickness. We compared SWVs to the modified Rodnan skin score (mRSS). Twenty-two healthy controls (mean age: 52.0; range: 19-88; 7 female) underwent the same protocol. RESULTS SWV pattern analysis (homogeneous vs heterogeneous) detected SSc with sensitivity/specificity/negative predictive value/positive predictive value0.79/0.81/0.91/0.62 in transverse and 0.75/0.18/0.91/0.56 in longitudinal orientation. In patients we found poor correlation between SWVs and mRSS but a cutoff of mRSSE = 20 separated them significantly (p < 0.01). Skin and muscle fascia were significantly thicker in patients vs. controls (p < 0.001). CONCLUSION SSc involves more than increased skin and fascial thickness which is not fully represented by mRSS. Elasticity differs in muscles with and without SSc. The former shows higher SWV and increased heterogeneity in transversal planes of muscular fibers.
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Affiliation(s)
- Manuel Kolb
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany.
| | - Felix Peisen
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany
| | - Kaspar Ekert
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany
| | - Theodoros Xenitidis
- Department of Internal Medicine II, Eberhard-Karls-University, Tuebingen, Germany
| | - Jan Fritz
- Johns Hopkins University School of Medicine, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD
| | | | - Jörg Henes
- Department of Internal Medicine II, Eberhard-Karls-University, Tuebingen, Germany
| | - Marius Horger
- Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany
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Kodesho T, Taniguchi K, Kato T, Katayose M. Intramuscular differences in shear modulus of the rectus femoris muscle during passive knee flexion. Eur J Appl Physiol 2021; 121:1441-1449. [PMID: 33620546 DOI: 10.1007/s00421-021-04644-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 02/14/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to determine (1) intramuscular regional differences in the changes in the shear modulus of the rectus femoris (RF) muscle during passive knee flexion and (2) the relationship between shear modulus and passive knee extension torque. METHOD The shear modulus maps as an index of muscle stiffness and the passive torque were obtained at seven regions during passive knee flexion at 2°/s within a knee joint range of motion of 0°-130° in 16 healthy males. RESULTS The shear modulus of RF increased with the knee angle of flexion. The shear modulus of each longitudinal region was greater in the order of proximal, central, and distal region (p < 0.05). The relationship between the shear modulus and passive torque was highly fitted for all 16 subjects (p < 0.05). The mean coefficient of determination (R2) at second-order polynomial model per subject was 0.96 (± 0.03; range 0.61-0.99), and whole group was 0.58 (± 0.03; range 0.54-0.64) in all regions. CONCLUSIONS The passive stiffness of RF was higher in the proximal region than in the other regions during passive knee flexion. Furthermore, the shear modulus-passive torque was related regardless of the measurement region within a muscle, and the results suggest that the passive knee extension torque reflects passive muscle stiffness of the RF.
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Affiliation(s)
- Taiki Kodesho
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Keigo Taniguchi
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, West 17, South 1, Chuo-ku, Sapporo City, Japan.
| | - Takuya Kato
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Masaki Katayose
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, West 17, South 1, Chuo-ku, Sapporo City, Japan
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18
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Kodesho T, Taniguchi K, Kato T, Mizoguchi S, Yamakoshi Y, Watanabe K, Fujimiya M, Katayose M. Relationship between shear elastic modulus and passive force of the human rectus femoris at multiple sites: a Thiel soft-embalmed cadaver study. J Med Ultrason (2001) 2021; 48:115-121. [PMID: 33576917 DOI: 10.1007/s10396-020-01076-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Estimation of muscle passive force from elasticity using shear wave elastography (SWE) has been reported. However, the relationship between the elasticity and passive force of human muscles has not been elucidated. This study investigated the elastic modulus-passive force relationship in human skeletal muscles at multiple sites. METHODS Four rectus femoris (RF) muscles were dissected from a human Thiel-embalmed cadaver. Calibration weights (0-600 g in 60-g increments) were applied to the distal tendon via a pulley system, and the shear elastic modulus as an index of elasticity was measured using SWE. The shear elastic modulus of the RF was measured at the proximal, central, and distal portions. RESULTS The results demonstrated that the relationships between the elasticity in the longitudinal direction of the muscle and the passive force were nearly linear for all tested sites, with coefficients of determination ranging from 0.813 to 0.993. CONCLUSION Shear wave elastography may be used as an indirect method to measure the changing passive force at any site within human muscles.
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Affiliation(s)
- Taiki Kodesho
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Keigo Taniguchi
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, West 17, South 1, Chuo-ku, Sapporo, Japan.
| | - Takuya Kato
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | - Shougo Mizoguchi
- Second Division of Anatomy, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | | | - Kota Watanabe
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, West 17, South 1, Chuo-ku, Sapporo, Japan
| | - Mineko Fujimiya
- Second Division of Anatomy, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, School of Health Sciences, Sapporo Medical University, West 17, South 1, Chuo-ku, Sapporo, Japan
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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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20
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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: 27] [Impact Index Per Article: 6.8] [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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Chang CH, Huang CC, Wang YH, Chou FJ, Chen JW. Ultrasound Shear-Wave Elastography of the Tongue in Adults with Obstructive Sleep Apnea. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1658-1669. [PMID: 32402674 DOI: 10.1016/j.ultrasmedbio.2020.03.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 03/11/2020] [Accepted: 03/24/2020] [Indexed: 05/17/2023]
Abstract
Obstructive sleep apnea (OSA) is a chronic breathing disorder characterized by intermittent sleep state-dependent upper airway (UA) collapse. The tongue comprises the primary UA dilator muscle and plays an essential role in the pathogenesis of OSA. We examined whether tongue stiffness measurement using ultrasound (US) shear wave elastography (SWE) is useful for predicting the existence of OSA. Forty-six participants (20 healthy controls and 26 patients with OSA) underwent transcutaneous submental SWE using a US system. Quantification with a shear modulus of 0-200 kPa was recorded during normal breathing and Müller's maneuver (MM). Polysomnography was used as the reference standard. Mid-sagittal tongue stiffness was significantly higher in awake patients with OSA than in controls during normal breathing and the MM (p < 0.0001). The posterior third of the tongue in patients with OSA had the highest value of shear modulus during the MM (p < 0.001). With cut-offs of 27.6 and 35.2 kPa for the whole tongue and posterior third during the MM, respectively, the sensitivity obtained was 69.2% and 76.9%, and the specificity was 85% and 95%, respectively, for detecting OSA. The corresponding areas under the receiver operating characteristic curve were 0.82 and 0.88, respectively. US SWE may have the potential for non-invasive tongue stiffness measurement in OSA.
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Affiliation(s)
- Chun-Hsiang Chang
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital, New Taipei City, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Otolaryngology-Head and Neck Surgery, National Taiwan University Hospital, Taipei City, Taiwan
| | - Chih-Chung Huang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan City, Taiwan
| | - Ya-Hui Wang
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Medical Research Center, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Fang-Ju Chou
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Medical Research Center, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Jeng-Wen Chen
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital, New Taipei City, Taiwan; School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Otolaryngology-Head and Neck Surgery, National Taiwan University Hospital, Taipei City, Taiwan.
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Wu J, Qian Z, Liang W, Liu J, Ren L, Ren L. In vivo assessment of material properties of muscles and connective tissues around the knee joint based on shear wave elastography. J Mech Behav Biomed Mater 2020; 109:103829. [PMID: 32543400 DOI: 10.1016/j.jmbbm.2020.103829] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 01/11/2023]
Abstract
Previous studies on knee biomechanics have mainly focused on the joint structure itself, largely neglecting the material properties of the muscles and connective tissues around the knee joint. Therefore, this study was purposed to conduct a systematic in vivo examination of the material properties of muscles, tendons, and ligaments, and investigated the respective influences of gender and age on the material properties. The participants were 50 healthy males and females within the following four age groups: 21-30 years, 31-40 years, 41-50 years, and above 51 years. The Young's moduli of the muscles, tendons, and ligaments around the knee joint were measured by shear wave elastography (SWE). Analysis of the Young's modulus results showed that excellent repeatability could be achieved by using SWE. For muscles, the intraclass correlation coefficient (ICC) and 95% confidence interval (CI) ranged between 0.952 and 0.987, and 0.923 and 0.992, respectively. The ICC ranged from 0.920 to 0.941, and the 95% CI was between 0.872 and 0.969 for tendons and ligaments. Additionally, the Young's moduli of the muscles, tendons, and ligaments of males were greater than those of females. With the exception for medial patellar retinaculum (MPR), the Young's moduli of other observed tissues decreased with age for both males and females, indicating that age has a significant impact on the Young's moduli of muscles, tendons, and ligaments. Hence, SWE is a reliable and repeatable technique that can be used to assess the Young's moduli of the muscles, tendons, and ligaments around the knee joint. Furthermore, gender and age affects the material properties. The results of this study provide an in vivo database of the material properties of muscles and connective tissues, and thus may prove useful for the prevention and treatment of knee joint injuries and diseases.
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Affiliation(s)
- Jianan Wu
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130025, PR China
| | - Zhihui Qian
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130025, PR China
| | - Wei Liang
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130025, PR China
| | - Jing Liu
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130025, PR China.
| | - Luquan Ren
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130025, PR China
| | - Lei Ren
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, 130025, PR China; School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, M13 9PL, UK.
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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: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Guo R, Xiang X, Wang L, Zhu B, Cheng S, Qiu L. Quantitative Assessment of Keloids Using Ultrasound Shear Wave Elastography. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1169-1178. [PMID: 32063394 DOI: 10.1016/j.ultrasmedbio.2020.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 01/06/2020] [Accepted: 01/13/2020] [Indexed: 02/08/2023]
Abstract
This study was aimed at investigating the value of shear wave elastography (SWE) in quantitative evaluation of keloids. A total of 87 patients with 139 keloids were enrolled. Vancouver scar scale (VSS) scores were recorded. Thickness and blood flow grade were evaluated using high-frequency ultrasound. Skin stiffness (mean speed of shear wave, Cmean) was evaluated using SWE in both transverse and longitudinal sections. All measurements were performed in both keloids and site-matched unaffected skin (normal controls). The reliability of measurements was evaluated using intra- and inter-class correlation coefficients by two observers. Inter- and intra-observer repeatability was excellent (correlation coefficient > 0.99, p < 0.01). The SWE results revealed a significant increase in Cmean in keloids (p < 0.001) compared with the normal controls. Cmean in the longitudinal section was greater than that in the transverse section for keloids (p < 0.001). Cmean was highly positively correlated with VSS score (r = 0.904, p < 0.001), moderately positively correlated with thickness (r = 0.490, p < 0.001) and less positively correlated with blood flow (r = 0.231, p < 0.01). This non-invasive, tolerable and convenient imaging technique could be an effective tool for objectively evaluating keloid stiffness in the future, thus laying a foundation for the treatment and evaluation of keloids.
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Affiliation(s)
- Ruiqian Guo
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xi Xiang
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Liyun Wang
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Bihui Zhu
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shan Cheng
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Li Qiu
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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