Shear Wave Elastography of Myofascial Trigger Points Using a Compact Scanner

使用紧凑型扫描仪进行肌筋膜触发点的剪切波弹性成像

• 批准号: 9236961
• 负责人: Shigao Chen
• 金额: $ 17.49万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9236961
• 关键词: Address; Affect; Algorithms; American; Articular Range of Motion; Cervical; Clinical; Clinical Management; Clinical Research; Clinical Treatment; Data; Detection; Diagnosis; Diagnostic; Evaluation; Functional disorder; Heating; Image; Investigation; Literature; Manuals; Measurement; Measures; Motion; Movement; Musculoskeletal Pain; Myofascial Pain Syndromes; Myofascial Trigger Point; Nature; Neck; Needles; Nodule; Numeric Rating Scale; Outcome Measure; Pain; Pain management; Palpable; Palpation; Patient Self-Report; Patients; Periodicity; Physiologic pulse; Population; Quantitative Evaluations; Sampling; Short Interspersed Nucleotide Elements; Signal Transduction; Skeletal Muscle; System; Technology; Testing; Time; Tissues; Transducers; Ultrasonic Transducer; Ultrasonography; Update; clinical Diagnosis; clinical diagnostics; clinical translation; common treatment; cost; design; digital; disability; effective therapy; elastography; experience; experimental study; in vivo; indexing; insight; laptop; new technology; novel; pain symptom; point of care; portability; pressure; prototype; reconstruction; research clinical testing; tool; transmission process; trigger point; user-friendly; vibration; voltage

PROJECT SUMMARY Myofascial pain is the leading cause of musculoskeletal pain, which affects 85% of the population at some point during their lives and costs Americans more than $50 billion each year. Myofascial pain is characterized by the presence of myofascial trigger points (MTrP), which are hard, palpable, discrete nodules located within taut bands of skeletal muscles that are painful upon compression. Current diagnosis for myofascial pain relies on clinical palpation, which has low reliability. The lack of objective and quantitative clinical diagnostic and outcome measures has led to much controversy regarding myofascial pain and MTrPs, and has resulted in an inability to generate an objective diagnosis, isolate a mechanism of action of effective therapies, or accurately assess the benefits of treatment. In this study, we propose a new technology, Continuous Oscillation Shearwave Elastography (COSE), which uses shear waves generated by continuous vibration of the ultrasound transducer for real-time, high frame rate, quantitative, 2D elastography imaging of MTrPs. COSE does not require the transmission of high voltage, long duration “push” beams, thus can be implemented on portable, compact, low-cost ultrasound scanners. The following specific aims are proposed. Aim 1: Implement and Optimize COSE on the GE Logiq e Compact Scanner. We will implement COSE on the Logiq e laptop scanner with a user friendly interface for on-line display and continuous update of 2D elastograms. A novel pulse-echo sequence will be used to achieve high frame rate of shear wave detection on the Logiq e. Timing of pulse-echo will be carefully designed to automatically remove tissue strains (due to transducer compression) from the shear waves in the detected motion. Phantom experiments and in vivo tests on patients with MTrPs will be used to validate and optimize the COSE prototype. Aim 2: Pilot Clinical Study. We will use the COSE prototype developed in Aim 1 to study 40 patients with dry needling, which is a common treatment for MTrPs and has been shown to reduce trigger point stiffness. COSE measurements will be obtained before and after the first dry needling treatment, and at week 3 after the final dry needling treatment. COSE results will be compared to clinical evaluations of the MTrPs, including palpation diagnosis by experienced clinicians, pain numeric rating scale, pain pressure threshold, Neck Disability Index, and the cervical range of motion. Successful completion of this project will result in a low-cost, safe, portable, high frame rate, 2D ultrasound shear wave elastography system for objective and quantitative evaluation of MTrPs. This tool will be ideal for point-of-care diagnosis of myofascial pain and treatment evaluation, which is also crucial for investigating the mechanism of action to develop effective therapies.

项目摘要 肌筋膜疼痛是肌肉骨骼疼痛的主要原因，在某些人中影响85％的人群 他们的生命中的观点和每年使美国人超过500亿美元。肌筋膜疼痛是特征的 通过存在肌筋膜触发点（MTRP），这些触发点（MTRP）很难，可显着的，离散的结节 压缩后痛苦的骨骼肌的拉长带。当前的肌膜疼痛诊断依赖 关于临床触诊，可靠性较低。缺乏客观和定量的临床诊断和 结果措施导致了有关肌筋膜疼痛和MTRP的广泛争议，并导致了 无法产生客观诊断，隔离有效疗法的作用机制或准确 评估治疗的好处。在这项研究中，我们提出了一种新技术，连续振荡 剪力波弹性图（COSE），使用通过连续振动产生的剪切波 超声传感器用于实时，高帧速率，定量，2D弹性成像的MTRPS。 cose 不需要传输高电压，长时间“推”梁，因此可以在 便携式，紧凑，低成本的超声扫描仪。提出了以下特定目标。 AIM 1：在GE Logiq e紧凑型扫描仪上实现并优化COSE。我们将实施cose Logiq e笔记本电脑扫描仪，具有用于在线显示和连续更新2D的用户友好接口 弹性图。新型的脉搏回声序列将用于实现高框架的剪切波检测速率 logiq e。脉搏回声的时间将经过仔细设计以自动去除组织菌株（由于 来自检测到的运动中的剪切波的换能器压缩）。幻影实验和体内测试 对于MTRP的患者，将用于验证和优化COSE原型。 AIM 2：试点临床研究。我们将使用AIM 1中开发的COSE原型研究40例干燥患者 针刺，这是MTRP的常见治疗方法，已被证明可以降低触发点刚度。 cose 测量将在第一次干点处理之前和之后获得，并在最终之后的第3周获得 干针的治疗。将COSE结果与MTRP的临床评估进行比较，包括Palmation 经验丰富的临床医生诊断，疼痛数字评分量表，疼痛压力阈值，颈部残疾指数， 和宫颈运动范围。 该项目的成功完成将导致低成本，安全，便携式，高帧速率，2D超声波 用于MTRP的客观和定量评估的剪切波弹性系统。此工具将是理想的选择 肌筋膜疼痛和治疗评估的护理点诊断，这对于研究 开发有效疗法的作用机制。