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斑点追踪超声心动图在肌肉骨骼系统中的应用与验证

Musculoskeletal application and validation of speckle-tracking ultrasonography.

作者信息

Frich Lars Henrik, Lambertsen Kate Lykke, Hjarbaek John, Dahl Jordi Sanchez, Holsgaard-Larsen Anders

机构信息

Department of Orthopaedics and Traumatology, Odense University Hospital, J.B. Winsloewsvej 4, 5000, Odense, Denmark.

Orthopaedic research unit, University of Southern Denmark, J.B. Winsloewsvej 4, 5000, Odense, Denmark.

出版信息

BMC Musculoskelet Disord. 2019 May 4;20(1):192. doi: 10.1186/s12891-019-2562-8.

Abstract

BACKGROUND

Diseased, injured, or dysfunctional skeletal muscles may demonstrate abnormal function and contractility. Currently, only few in vivo imaging techniques are able to characterize the contractile properties of muscle tissue. This study aimed to test the hypothesis that muscle strain can be tracked in two upper extremity skeletal muscles by speckle-tracking ultrasonography (STU) and correlates with isometric muscle contractions.

METHODS

A convenience sample of 10 healthy, adult volunteers with normal shoulder function were tested. The 5 women and 5 men had a mean age of 45 years (range: 39-59 years) and BMI < 30. STU was applied to the supraspinatus (SS) and biceps brachii (BB) muscles using a M11 L-MHz linear transducer (frequency 8-15 MHz) hooked to a Vivid E 9TM ultrasound machine. Strain validation was performed by correlating peak strain against standardized sub-maximal, isometric load conditions of the two muscles (20-80% of maximal voluntary contraction) using a custom-built muscle dynamometer based on strain-gauge technique. Data were analyzed offline using the EchoPac speckle-tracking software and were blinded to the examiner.

RESULTS

Intramuscular strain measured by STU in the SS and BB muscles showed moderate to strong correlations with external muscle load (SS: r = - 0.76, p < 0.0001 and BB: r = - 0.60, p < 0.0001). We found strain to vary from approximately 10-20% during increasing submaximal, isometric conditions.

CONCLUSIONS

We demonstrate that STU can be applied on healthy skeletal musculature (SS and BB muscles). The observed correlations between strain and isometric contractions suggest a valid technique. However, the concept of measuring muscle strain non-invasively needs further investigation for validity, accuracy, responsiveness, and reliability before its therapeutic and research potential can be realized.

摘要

背景

患病、受伤或功能失调的骨骼肌可能表现出异常的功能和收缩性。目前,只有少数体内成像技术能够表征肌肉组织的收缩特性。本研究旨在验证以下假设:通过斑点追踪超声(STU)可以在两块上肢骨骼肌中追踪肌肉应变,并且该应变与等长肌肉收缩相关。

方法

对10名肩部功能正常的健康成年志愿者进行了便利抽样测试。其中5名女性和5名男性,平均年龄45岁(范围:39 - 59岁),体重指数(BMI)< 30。使用连接到Vivid E 9TM超声仪的M11 L - MHz线性换能器(频率8 - 15 MHz)对冈上肌(SS)和肱二头肌(BB)进行STU检查。通过将峰值应变与基于应变片技术的定制肌肉测力计测量的两块肌肉的标准化次最大等长负荷条件(最大自主收缩的20 - 80%)进行关联,来进行应变验证。使用EchoPac斑点追踪软件对数据进行离线分析,且分析人员对数据不知情。

结果

STU测量的SS和BB肌肉内的应变与外部肌肉负荷呈中度至强相关性(SS:r = - 0.76,p < 0.0001;BB:r = - 0.60,p < 0.0001)。我们发现,在次最大等长条件增加期间,应变从大约10% - 20%变化。

结论

我们证明STU可应用于健康的骨骼肌(SS和BB肌肉)。观察到的应变与等长收缩之间的相关性表明该技术有效。然而,在实现其治疗和研究潜力之前,非侵入性测量肌肉应变的概念在有效性、准确性、反应性和可靠性方面需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0b2/6499961/0507b1922ccd/12891_2019_2562_Fig1_HTML.jpg

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