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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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2
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Oudeman J, Mazzoli V, Marra MA, Nicolay K, Maas M, Verdonschot N, Sprengers AM, Nederveen AJ, Strijkers GJ, Froeling M. A novel diffusion-tensor MRI approach for skeletal muscle fascicle length measurements. Physiol Rep 2017; 4:4/24/e13012. [PMID: 28003562 PMCID: PMC5210383 DOI: 10.14814/phy2.13012] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 09/26/2016] [Indexed: 12/29/2022] Open
Abstract
Musculoskeletal (dys‐)function relies for a large part on muscle architecture which can be obtained using Diffusion‐Tensor MRI (DT‐MRI) and fiber tractography. However, reconstructed tracts often continue along the tendon or aponeurosis when using conventional methods, thus overestimating fascicle lengths. In this study, we propose a new method for semiautomatic segmentation of tendinous tissue using tract density (TD). We investigated the feasibility and repeatability of this method to quantify the mean fascicle length per muscle. Additionally, we examined whether the method facilitates measuring changes in fascicle length of lower leg muscles with different foot positions. Five healthy subjects underwent two DT‐MRI scans of the right lower leg, with the foot in 15° dorsiflexion, neutral, and 30° plantarflexion positions. Repeatability of fascicle length measurements was assessed using Bland–Altman analysis. Changes in fascicle lengths between the foot positions were tested using a repeated multivariate analysis of variance (MANOVA). Bland–Altman analysis showed good agreement between repeated measurements. The coefficients of variation in neutral position were 8.3, 16.7, 11.2, and 10.4% for soleus (SOL), fibularis longus (FL), extensor digitorum longus (EDL), and tibialis anterior (TA), respectively. The plantarflexors (SOL and FL) showed significant increase in fascicle length from plantarflexion to dorsiflexion, whereas the dorsiflexors (EDL and TA) exhibited a significant decrease. The use of a tract density for semiautomatic segmentation of tendinous structures provides more accurate estimates of the mean fascicle length than traditional fiber tractography methods. The method shows moderate to good repeatability and allows for quantification of changes in fascicle lengths due to passive stretch.
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Affiliation(s)
- Jos Oudeman
- Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Valentina Mazzoli
- Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands.,Orthopedic Research Lab, Radboud UMC, Nijmegen, the Netherlands.,Biomedical NMR, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Marco A Marra
- Orthopedic Research Lab, Radboud UMC, Nijmegen, the Netherlands
| | - Klaas Nicolay
- Biomedical NMR, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Mario Maas
- Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Nico Verdonschot
- Orthopedic Research Lab, Radboud UMC, Nijmegen, the Netherlands.,Laboratory of Biomechanical Engineering, University of Twente, Enschede, the Netherlands
| | - Andre M Sprengers
- Orthopedic Research Lab, Radboud UMC, Nijmegen, the Netherlands.,Laboratory of Biomechanical Engineering, University of Twente, Enschede, the Netherlands
| | - Aart J Nederveen
- Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Gustav J Strijkers
- Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, the Netherlands
| | - Martijn Froeling
- Department of Radiology, University Medical Center, Utrecht, the Netherlands
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Chianca V, Albano D, Messina C, Cinnante CM, Triulzi FM, Sardanelli F, Sconfienza LM. Diffusion tensor imaging in the musculoskeletal and peripheral nerve systems: from experimental to clinical applications. Eur Radiol Exp 2017; 1:12. [PMID: 29708174 PMCID: PMC5909344 DOI: 10.1186/s41747-017-0018-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 08/01/2017] [Indexed: 12/14/2022] Open
Abstract
Magnetic resonance imaging (MRI) is a well-established imaging modality which is used in all districts of the musculoskeletal and peripheral nerve systems. More recently, initial studies have applied multiparametric MRI to evaluate quantitatively different aspects of musculoskeletal and peripheral nerve diseases, thus providing not only images but also numbers and clinical data. Besides 1H and 31P magnetic resonance spectroscopy, diffusion-weighted imaging (DWI) and blood oxygenation level-dependent imaging, diffusion tensor imaging (DTI) is a relatively new MRI-based technique relying on principles of DWI, which has traditionally been used mainly for evaluating the central nervous system to track fibre course. In the musculoskeletal and peripheral nerve systems, DTI has been mostly used in experimental settings, with still few indications in clinical practice. In this review, we describe the potential use of DTI to evaluate different musculoskeletal and peripheral nerve conditions, emphasising the translational aspects of this technique from the experimental to the clinical setting.
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Affiliation(s)
- Vito Chianca
- 1Department of Advanced Biomedical Sciences, Università Federico II, Via Pansini 5, 80131 11 Napoli, Italy
| | - Domenico Albano
- 2Department of Radiology, DIBIMED, Università di Palermo, Via del Vespro 127, 90127 Palermo, Italy
| | - Carmelo Messina
- 7Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milano, Italy
| | - Claudia Maria Cinnante
- 3Unit of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy
| | - Fabio Maria Triulzi
- 3Unit of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy.,5Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Francesco Sardanelli
- 4Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Italy.,6Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, 20122 Milano, Italy
| | - Luca Maria Sconfienza
- 6Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, 20122 Milano, Italy.,7Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milano, Italy
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Isobe T, Okamoto Y, Hirano Y, Ando H, Takada K, Sato E, Shinoda K, Tadano K, Takei H, Kamizawa S, Mori Y, Suzuki H. Effect of biological factors on successful measurements with skeletal-muscle (1)H-MRS. Ther Clin Risk Manag 2016; 12:1133-7. [PMID: 27499626 PMCID: PMC4959760 DOI: 10.2147/tcrm.s84371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Our purpose in this study was to clarify whether differences in subject group attributes could affect data acquisition in proton magnetic resonance spectroscopy (1H-MRS). Methods Subjects without diabetes mellitus (DM) were divided into two groups (group A, in their 20s; group B, 30–60 years old). Subjects with DM formed group C (30–60 years old). The numbers of subjects were 19, 27, and 22 for group A, B, and C respectively. For all subjects, 1H-MRS measurements were taken of the soleus muscle (SOL) and the anterior tibial muscle (AT). We defined the success of the measurements by the detection of intramyocellular lipids. Moreover, we also measured the full width at half maximum of the water peaks for all subjects. Results The success rate was significantly higher for the AT (100%) than for the SOL (81.6%) (P<0.01). For the SOL, the success rate was 100% in group A, 85.2% in group B, and 77.3% in group C. There was a significant difference (P<0.05) between groups A and B, as well as between groups A and C. In all subjects, there was a significant difference (P<0.01) in the full width at half maximum (Hz) of the water peak between the AT and SOL measurements. Conclusion We conclude that differences in the age and DM history of subjects could affect the probability of successful 1H-MRS data acquisition.
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Affiliation(s)
- Tomonori Isobe
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | | | - Yuji Hirano
- Department of Radiology, University of Tsukuba Hospital, Ibaraki, Japan
| | - Hiroki Ando
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Kenta Takada
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Eisuke Sato
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, Tokyo, Japan
| | - Kazuya Shinoda
- Department of Radiology, Tsukuba Medical Center Hospital, Ibaraki, Japan
| | - Kiichi Tadano
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University, Tokyo, Japan
| | - Hideyuki Takei
- Department of Radiology, University of Tsukuba Hospital, Ibaraki, Japan
| | | | - Yutaro Mori
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Hiroaki Suzuki
- Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
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5
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Rockel C, Noseworthy MD. An exploration of diffusion tensor eigenvector variability within human calf muscles. J Magn Reson Imaging 2015; 43:190-202. [DOI: 10.1002/jmri.24957] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 05/13/2015] [Indexed: 11/06/2022] Open
Affiliation(s)
- Conrad Rockel
- McMaster School of Biomedical Engineering; McMaster University; Hamilton Ontario Canada
- Imaging Research; St. Joseph's Healthcare; Hamilton Ontario Canada
| | - Michael D. Noseworthy
- McMaster School of Biomedical Engineering; McMaster University; Hamilton Ontario Canada
- Imaging Research; St. Joseph's Healthcare; Hamilton Ontario Canada
- Department of Radiology; McMaster University; Hamilton Ontario Canada
- Department of Electrical and Computer Engineering; McMaster University; Hamilton Ontario Canada
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Hara Y, Ikoma K, Kido M, Sukenari T, Arai Y, Fujiwara H, Kawata M, Kubo T. Diffusion tensor imaging assesses triceps surae dysfunction after achilles tenotomy in rats. J Magn Reson Imaging 2014; 41:1541-8. [DOI: 10.1002/jmri.24707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 06/30/2014] [Accepted: 06/30/2014] [Indexed: 11/07/2022] Open
Affiliation(s)
- Yusuke Hara
- Department of Orthopaedics; Graduate School of Medical Science, Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Kazuya Ikoma
- Department of Orthopaedics; Graduate School of Medical Science, Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Masamitsu Kido
- Department of Orthopaedics; Graduate School of Medical Science, Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Tsuyoshi Sukenari
- Department of Orthopaedics; Graduate School of Medical Science, Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Yuji Arai
- Department of Orthopaedics; Graduate School of Medical Science, Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Hiroyoshi Fujiwara
- Department of Orthopaedics; Graduate School of Medical Science, Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Mitsuhiro Kawata
- Department of Anatomy and Neurobiology; Graduate School of Medical Science, Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Toshikazu Kubo
- Department of Orthopaedics; Graduate School of Medical Science, Kyoto Prefectural University of Medicine; Kyoto Japan
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