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Ham S, Kim S, Choi H, Lee Y, Lee H. Greater Muscle Stiffness during Contraction at Menstruation as Measured by Shear-Wave Elastography. TOHOKU J EXP MED 2021; 250:207-213. [PMID: 32238619 DOI: 10.1620/tjem.250.207] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
It is important to measure mechanical properties of muscle, since muscle stiffness is an important component of stabilizing or controlling joint stability. The levels of sex hormones especially estrogen vary over the phase of the menstrual cycle and impact the mechanical properties of soft tissue such as muscle, tendon, and ligaments due to the presence of 17-β estradiol receptor in human connective tissues. Recently, shear-wave elastography (SWE), based on ultrasound imaging, has been used as an accurate technique for visualizing and assessing tissue stiffness. The purpose of this study was to compare the muscle stiffness at rest and during contraction condition between the early follicular phase (menstruation) and ovulation in young women, measured using SWE. Thirty-seven young women with regular menstrual cycles completed this study throughout one full menstrual cycle. Stiffness of lower limb muscles such as the rectus femoris, biceps femoris, tibialis anterior, and medial gastrocnemius was measured at resting and during contraction conditions using SWE during menstruation and ovulation. All muscles showed significantly greater stiffness during the menstruation than ovulation when muscles were actively contracted (P < 0.05), whereas no significant differences in muscle stiffness at rest were noted across phase of the menstrual cycle. These significant findings suggest that muscular factors are changed with estradiol fluctuations; muscles are less stiff during ovulation where the levels of estradiol peak when muscles in a contraction condition. As muscle stiffness is an important part of joint stability, these differences should be recognized to prevent the risk of musculoskeletal injuries.
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Affiliation(s)
- Seoungho Ham
- Department of Physical Therapy, Gachon University
| | - Sujin Kim
- Department of Physical Therapy, Gachon University
| | | | - Youngjin Lee
- Department of Radiological Science, Gachon University
| | - Haneul Lee
- Department of Physical Therapy, Gachon University
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Dzoic Dominkovic M, Ivanac G, Bojanic K, Kralik K, Smolic M, Divjak E, Smolic R, Brkljacic B. Exploring Association of Breast Pain, Pregnancy, and Body Mass Index with Breast Tissue Elasticity in Healthy Women: Glandular and Fat Differences. Diagnostics (Basel) 2020; 10:diagnostics10060393. [PMID: 32532143 PMCID: PMC7345881 DOI: 10.3390/diagnostics10060393] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 12/15/2022] Open
Abstract
Breast sonoelastography is a relatively novel ultrasound (US) method that enables estimation of tissue stiffness to estimate the elasticity of normal breast tissue and seek to correlate it with well-known breast cancer risk factors. Two hundred women of different age were included in the study and completed a questionnaire about personal, familiar, and reproductive history. Glandular and fatty tissue elasticity in all breast quadrants was measured by shear wave elastography (SWE). Mean elastographic values of breast tissue were calculated and compared to personal history risk factors. Elasticity of normal glandular tissue (66.4 kilopascals (kPa)) was higher than fatty tissue (26.1 kPa) in all breast quadrants and in both breasts. Lower outer quadrant (LOQ) had the lowest elasticity values of both parenchyma and fat. Higher elasticity values of breast tissue were confirmed in the left breast than in the right breast. Glandular and fat tissue elasticity negatively correlated with body mass index (BMI). Women with mastodynia had higher glandular elastographic values compared to subjects without breast pain. Nuliparity was also associated with higher elasticity of glandular breast tissue. The results of this study are promising and could, over time, contribute to a better understanding of glandular breast tissue elasticity as a potential risk factor for breast cancer.
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Affiliation(s)
- Martina Dzoic Dominkovic
- Department of Radiology, General Hospital Orasje, 3rd Street, 76270 Orasje, Bosnia and Herzegovina;
| | - Gordana Ivanac
- Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, Avenue Gojka Suska 6, 10000 Zagreb, Croatia; (G.I.); (E.D.); (B.B.)
- University of Zagreb School of Medicine, Salata 3, 10000 Zagreb, Croatia
| | - Kristina Bojanic
- Department of Biophysics and Radiology, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia;
- Department of Biophysics and Radiology, Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Radiology, Health Center Osijek, 31000 Osijek, Croatia
| | - Kristina Kralik
- Department of Medical Statistics and Medical Informatics, Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Martina Smolic
- Department of Pharmacology and Biochemistry, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia;
- Department of Pharmacology, Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Eugen Divjak
- Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, Avenue Gojka Suska 6, 10000 Zagreb, Croatia; (G.I.); (E.D.); (B.B.)
- University of Zagreb School of Medicine, Salata 3, 10000 Zagreb, Croatia
| | - Robert Smolic
- Department of Pathophysiology, Physiology and Immunology, Faculty of Dental Medicine and Health Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Pathophysiology, Faculty of Medicine Osijek, J.J. Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Medicine, Division of Gastroenterology/Hepatology, University Hospital Osijek, 31000 Osijek, Croatia
- Correspondence: ; Tel.: +385-31-512-800; Fax: +385-31-512-833
| | - Boris Brkljacic
- Department of Diagnostic and Interventional Radiology, University Hospital Dubrava, Avenue Gojka Suska 6, 10000 Zagreb, Croatia; (G.I.); (E.D.); (B.B.)
- University of Zagreb School of Medicine, Salata 3, 10000 Zagreb, Croatia
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Gity M, Arabkheradmand A, Taheri E, Shakiba M. Diagnostic investigation of breast magnetic resonance imaging in malignant and benign mass lesions. Arch Med Sci 2018; 14:1061-1069. [PMID: 30154889 PMCID: PMC6111366 DOI: 10.5114/aoms.2016.62281] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 08/01/2016] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION Breast magnetic resonance imaging (BMRI) has been identified as a valuable modality in the diagnosis of breast cancer and monitoring the response to chemotherapy. The aim of this study was to evaluate the relative importance of different descriptors of breast masses in contrast-enhanced breast MRI. MATERIAL AND METHODS In a database of pathologically proven breast lesions, in total 433 masses in 312 patients detected by contrast-enhanced breast MRI were selected. All images were assessed according to the MRI BI-RADS lexicon and those with significant positive MRI findings (BI-RADS categories 3, 4, 5) were enrolled in the study. RESULTS Mean age of patients was 45.09 ±10.5 years. The most frequent BI-RADS score was 4 (60.7%), followed by 3 (27%). Among the morphologic descriptors of the enhancing masses, the findings most strongly associated with malignancy included spiculated margin (60.6%) and irregular shape (38%). Considering the dynamic descriptors, a wash-out pattern in the time-intensity curve was the most powerful finding associated with malignancy (27.9%). Among all breast MRI descriptors, the best odds ratio (OR) in association with malignancy was noted for speculated margin (OR = 10.2) followed by wash-out or plateau curves (OR = 6.1), size greater than 1 cm (OR = 4.3) and irregular shape (OR = 3.1). CONCLUSIONS It seems that morphologic descriptors of MRI BI-RADS for enhancing masses are quite specific, while dynamic descriptors of the masses are highly sensitive. Appropriate consideration and combination of different BI-RADS findings could help in better characterization of enhancing masses on breast MRI, lowering the rate of false positive reports and avoiding unnecessary biopsies.
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Affiliation(s)
- Masoumeh Gity
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Medical Imaging Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Arabkheradmand
- Department of Surgery, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Taheri
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
| | - Madjid Shakiba
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
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Paczkowska K, Rzymski P, Kubasik M, Opala T. Sonoelastography in the evaluation of capsule formation after breast augmentation - preliminary results from a follow-up study. Arch Med Sci 2016; 12:793-8. [PMID: 27478461 PMCID: PMC4947608 DOI: 10.5114/aoms.2015.49935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 11/28/2014] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION There are many indications for breast augmentation, including reconstruction after mastectomy, correction of congenital disorders and cosmetic procedures. The most frequent local complication of this surgery is capsule formation due to fibrosis. The aim of the study was to assess the usefulness of sonoelastography in the evaluation of capsule formation around silicone implants. MATERIAL AND METHODS The study group included 13 patients aged 20 to 41, who underwent breast augmentation with silicone implants. Their 26 breasts were examined before surgery, 7 and 14 days and a minimum of 8.5 months after surgery. The breast stiffness was assessed with tonometry and shear wave elastography to evaluate elasticity of the breast tissue and capsule formation after surgery. RESULTS We assessed the correlation between capsular elasticity measured at successive visits and the Baker scale. There were no significant relationships between any pairs of variables (p > 0.05). We also analyzed the correlation between the time of the follow-up and changes in the tissue elasticity of every region - no significant relationship was found. The greatest decrease in pericapsular elasticity was established in lower and inner quadrants. Moreover, there was a significant difference between the elasticity of the tissue before and 1 week after surgery (p < 0.05) and no significant changes in the elasticity before surgery and at the end of the follow-up. CONCLUSIONS Sonoelastography is precise in evaluation of capsule formation after breast augmentation. It may show changes that cannot be assessed using palpation.
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Affiliation(s)
- Katarzyna Paczkowska
- Department of Mother's and Child's Health, Poznan University of Medical Sciences, Gynecologic and Obstetrical University Hospital, Poznan, Poland
| | - Paweł Rzymski
- Department of Mother's and Child's Health, Poznan University of Medical Sciences, Gynecologic and Obstetrical University Hospital, Poznan, Poland
| | - Mikołaj Kubasik
- Individual Plastic Surgery Practice, Poznan-Zakrzewo, Poland
| | - Tomasz Opala
- Department of Mother's and Child's Health, Poznan University of Medical Sciences, Gynecologic and Obstetrical University Hospital, Poznan, Poland
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Hao SY, Ou B, Li LJ, Peng YL, Wang Y, Liu LS, Xiao Y, Liu SJ, Wu CJ, Jiang YX, Parajuly SS, Xu P, Hao Y, Li J, Zhi H, Luo BM. Could ultrasonic elastography help the diagnosis of breast cancer with the usage of sonographic BI-RADS classification? Eur J Radiol 2015; 84:2492-500. [DOI: 10.1016/j.ejrad.2015.08.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 07/06/2015] [Accepted: 08/26/2015] [Indexed: 12/21/2022]
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Vantyghem MC, Balavoine AS, Douillard C, Defrance F, Dieudonne L, Mouton F, Lemaire C, Bertrand-Escouflaire N, Bourdelle-Hego MF, Devemy F, Evrard A, Gheerbrand D, Girardot C, Gumuche S, Hober C, Topolinski H, Lamblin B, Mycinski B, Ryndak A, Karrouz W, Duvivier E, Merlen E, Cortet C, Weill J, Lacroix D, Wémeau JL. How to diagnose a lipodystrophy syndrome. ANNALES D'ENDOCRINOLOGIE 2012; 73:170-89. [PMID: 22748602 DOI: 10.1016/j.ando.2012.04.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 04/25/2012] [Indexed: 11/15/2022]
Abstract
The spectrum of adipose tissue diseases ranges from obesity to lipodystrophy, and is accompanied by insulin resistance syndrome, which promotes the occurrence of type 2 diabetes, dyslipidemia and cardiovascular complications. Lipodystrophy refers to a group of rare diseases characterized by the generalized or partial absence of adipose tissue, and occurs with or without hypertrophy of adipose tissue in other sites. They are classified as being familial or acquired, and generalized or partial. The genetically determined partial forms usually occur as Dunnigan syndrome, which is a type of laminopathy that can also manifest as muscle, cardiac, neuropathic or progeroid involvement. Gene mutations encoding for PPAR-gamma, Akt2, CIDEC, perilipin and the ZMPSTE 24 enzyme are much more rare. The genetically determined generalized forms are also very rare and are linked to mutations of seipin AGPAT2, FBN1, which is accompanied by Marfan syndrome, or of BANF1, which is characterized by a progeroid syndrome without insulin resistance and with early bone complications. Glycosylation disorders are sometimes involved. Some genetically determined forms have recently been found to be due to autoinflammatory syndromes linked to a proteasome anomaly (PSMB8). They result in a lipodystrophy syndrome that occurs secondarily with fever, dermatosis and panniculitis. Then there are forms that are considered to be acquired. They may be iatrogenic (protease inhibitors in HIV patients, glucocorticosteroids, insulin, graft-versus-host disease, etc.), related to an immune system disease (sequelae of dermatopolymyositis, autoimmune polyendocrine syndromes, particularly associated with type 1 diabetes, Barraquer-Simons and Lawrence syndromes), which are promoted by anomalies of the complement system. Finally, lipomatosis is currently classified as a painful form (adiposis dolorosa or Dercum's disease) or benign symmetric multiple form, also known as Launois-Bensaude syndrome or Madelung's disease, which are sometimes related to mitochondrial DNA mutations, but are usually promoted by alcohol. In addition to the medical management of metabolic syndrome and the sometimes surgical treatment of lipodystrophy, recombinant leptin provides hope for genetically determined lipodystrophy syndromes, whereas modifications in antiretroviral treatment and tesamorelin, a GHRH analog, is effective in the metabolic syndrome of HIV patients. Other therapeutic options will undoubtedly be developed, dependent on pathophysiological advances, which today tend to classify genetically determined lipodystrophy as being related to laminopathy or to lipid droplet disorders.
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Affiliation(s)
- Marie-Christine Vantyghem
- Inserm U859, service d'endocrinologie et maladies métaboliques, hôpital Huriez, CHRU de Lille, 1, rue Polonovski, 59000 Lille, France.
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