Office-based elastographic technique for quantifying mechanical properties of skeletal muscle.
Office-based elastographic technique for quantifying mechanical properties of skeletal muscle.
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DOI：
10.7863/jum.2012.31.8.1209
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发表时间：
2012-08
期刊：
影响因子：
--
通讯作者：
Sikdar S
中科院分区：
文献类型：
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作者：
Ballyns JJ;Turo D;Otto P;Shah JP;Hammond J;Gebreab T;Gerber LH;Sikdar S
我们的目标是开发一种新的、有效的、易于管理的超声弹性成像方法，并评估其在门诊临床环境中提供骨骼肌粘弹性特性定量表征的能力。我们试图证明其有效性和临床应用评估肌筋膜触发点，这与肌筋膜疼痛综合征。使用手持式振动器在60至200赫兹的频率范围内对肌肉进行外部振动时进行超声成像。振动相位的空间梯度产生剪切波速，而剪切波速与组织的粘弹性有关。该方法通过校准的实验假体、健康志愿者的肱二头肌（n = 6）、有症状的轴颈痛患者的上斜方肌（n = 13）和无症状（无痛）对照参与者（n = 9）进行验证。利用实验模体，我们的方法能够定量测量剪切模量，错误率小于20%。正常肱二头肌的平均剪切模量±SD测量值为12.5±3.4 kPa，在使用更复杂的方法发表的数值范围内。高频刺激（> ~ 100hz; P < 0.05）时，肌筋膜活动触发点及周围肌肉组织的横波速度显著高于正常组织。现成的办公室设备可用于定量表征骨骼肌粘弹性特性，其估计值与使用更复杂的方法相当。我们使用这种方法的初步结果表明，自发性颈部疼痛和症状性肌筋膜触发点的患者在触发点部位和周围肌肉组织的组织异质性增加。
Our objectives were to develop a new, efficient, and easy-to-administer approach to ultrasound elastography and assess its ability to provide quantitative characterization of viscoelastic properties of skeletal muscle in an outpatient clinical environment. We sought to show its validity and clinical utility in assessing myofascial trigger points, which are associated with myofascial pain syndrome. Ultrasound imaging was performed while the muscle was externally vibrated at frequencies in the range of 60 to 200 Hz using a handheld vibrator. The spatial gradient of the vibration phase yielded the shear wave speed, which is related to the viscoelastic properties of tissue. The method was validated using a calibrated experimental phantom, the biceps brachii muscle in healthy volunteers (n = 6), and the upper trapezius muscle in symptomatic patients with axial neck pain (n = 13) and asymptomatic (pain-free) control participants (n = 9). Using the experimental phantom, our method was able to quantitatively measure the shear moduli with error rates of less than 20%. The mean shear modulus ± SD in the normal biceps brachii measured 12.5 ± 3.4 kPa, within the range of published values using more sophisticated methods. Shear wave speeds in active myofascial trigger points and the surrounding muscle tissue were significantly higher than those in normal tissue at high frequency excitations (>100 Hz; P < .05). Off-the-shelf office-based equipment can be used to quantitatively characterize skeletal muscle viscoelastic properties with estimates comparable to those using more sophisticated methods. Our preliminary results using this method indicate that patients with spontaneous neck pain and symptomatic myofascial trigger points have increased tissue heterogeneity at the trigger point site and the surrounding muscle tissue.