Quantitative Musculoskeletal Ultrasound

Gitto, Salvatore; Messina, Carmelo; Vitale, Nicolò Danilo; Albano, Domenico; Sconfienza, Luca Maria

doi:10.1055/s-0040-1709720

Cited by 10 publications

(16 citation statements)

References 95 publications

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“…Strain elastography enables us to evaluate non-invasively the mechanical properties of biologic tissues, specifically tissue stiffness, by assessing the displacement of soft tissue structures after external compression [6]. It is increasingly used in musculoskeletal settings, already having an established role in lateral epicondylitis and Achilles tendinopathy [4].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have shown that it might be used to highlight the softer appearance of the PF in plantar fasciitis, increasing the diagnostic performance of B-mode ultrasound and being supportive in doubtful cases with inconclusive ultrasound findings [7]. Some of the drawbacks of this technique, including the limited reproducibility and the qualitative nature of data, have led to the introduction of shear-wave elastography (SWE) as a quantitative and more objective tool to estimate soft tissues' stiffness by using an acoustic radiation force pulse sequence to produce shear waves that propagate perpendicularly from the transducer with transient structures displacements [6]. Although SWE was investigated first in other districts (i.e.…”

Section: Introductionmentioning

confidence: 99%

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Shear-wave elastography of the plantar fascia: a systematic review and meta-analysis

et al. 2023

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Purpose To assess the efficacy of shear-wave elastography (SWE) of the plantar fascia (PF) in identifying plantar fasciitis. Methods A literature search was conducted on the PubMed and Medline databases for articles published up to August 2022. The Newcastle–Ottawa scale was used to assess the risk of bias. We included original research studies in English dealing with the evaluation of patients with plantar fasciitis by means of SWE and including shear modulus (KPa) and/or shear-wave velocity (m/s). We compared healthy and pathologic PF stiffness using the standardised mean difference (SMD) in a random-effects model (95% CI). Results Five studies were included with a total of 158 pathologic PFs and 134 healthy PFs. No significant publication bias was detected. Studies were highly heterogeneous (p < 0.00001; I2 = 97%). Pathologic PFs showed significantly lower stiffness, with an SMD of − 3.00 m/s (95% confidence interval: − 4.95 to − 1.06, p = 0.002), compared to healthy PF. Conclusion Pathologic PFs present significantly lower stiffness than healthy PFs. However, the analysed studies are highly heterogeneous.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Shear-wave elastography of the plantar fascia: a systematic review and meta-analysis

et al. 2023

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“…2 SMI is currently being used for many diagnostic regions including musculoskeletal applications. 3 As it still remains unclear how far or in which way microvascularity is changed in compression neuropathies, SMI may be added as a new diagnostic tool for evaluating peripheral compression syndromes.…”

Section: Introductionmentioning

confidence: 99%

“…Superb microvascular imaging (SMI) itself is a modified Doppler algorithm enabling the visualisation of smaller vessels with slower blood flow compared with existing Doppler modalities 2 . SMI is currently being used for many diagnostic regions including musculoskeletal applications 3 . As it still remains unclear how far or in which way microvascularity is changed in compression neuropathies, SMI may be added as a new diagnostic tool for evaluating peripheral compression syndromes.…”

Section: Introductionmentioning

confidence: 99%

Intraneural vascularity of the median, ulnar and common peroneal nerve: Microvascular ultrasound and pathophysiological implications

Deeg

Mündel

Loizides

et al. 2023

Australas J Ultrason Med

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ObjectivesChanges in the microvascular environment are considered crucial in the pathogenesis of compression neuropathies. Several studies have demonstrated elevated intraneural vascularity in severe neuropathy compared with healthy subjects, where intraneural vascularity is considered predominantly undetectable. The aim of this study was to assess and quantify intraneural vasculature by superb microvascular imaging (SMI) in healthy volunteers in the median, ulnar and common peroneal nerve.MethodsIntraneural vascularity was quantified in 26 healthy volunteers (312 segments overall) by SMI sonography using a 22‐MHz linear transducer. Individual nerve segment vascularity was compared with the mean vascularity using one‐way ANOVA and Kruskal–Wallis tests, respectively. Vendor‐provided quantification and manual vessel count were compared by linear regression analysis.ResultsIntraneural vascularity was detectable in all nerve segments (100.0%). Vessel density was highest in the median nerve at the wrist (1.54 ± 0.44/mm2, P < 0.0001) and lowest in the sulcal ulnar nerve (0.90 ± 0.34/mm2, P < 0.0001). Vendor‐provided automated quantification severely overestimated vascular content compared with manual quantification.ConclusionSuperb microvascular imaging can facilitate the visualisation of nerve vascularity and even detect local variations in vessel density. The pathophysiological implications for peripheral neuropathies, especially compression neuropathies, warrant further investigation, but the absence of visible intraneural vasculature as a negative finding in the diagnostic of compression neuropathies should be interpreted with caution, as the intraneural vascularity may lie beyond the 18 MHz resolution power of a transducer.

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“…This imaging technique provides real-time information, making it particularly useful for dynamic assessments of musculoskeletal structures [14]. In addition to the US metrics using the bidimensional mode which includes muscle size, shape and brightness and quality [15], recent advances allow the muscle stiffness measurement [16].…”

Section: Introductionmentioning

confidence: 99%

Reproducibility of Anterior Scalene Stiffness Measurement with Shear Wave Elastography: An Inter-Examiner Reliability Study

Varol,

Sánchez-Jiménez,

Valera-Calero

et al. 2023

Ultraschall Med

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Purpose: Although previous studies highlighted the clinical relevance of the anterior scalene muscle (AS) in patients with neck pain or nerve compressive syndromes, evidence reporting the diagnostic accuracy of shear wave elastography (SWE) for assessing the AS stiffness properties is lacking. This study aimed to analyze the SWE inter-examiner reliability for calculating the Young’s modulus and shear wave speed of the AS muscle in asymptomatic subjects. Material and Methods: Using a linear transducer, ultrasound images of the antero-lateral neck region at C7 level were acquired in 35 healthy volunteers by one experienced examiner and one novel examiner. After codifying the images to blind the participant identity, trial and side, Young’s modulus and shear wave speed were obtained by an independent experienced rater in randomized order. Intra-class correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable changes (MDC) and coefficient of variation (CV%) were calculated. Results: The AS metrics assessed showed no side-to-side differences (p>0.05). Sex differences were found for muscle size (p=0.002), but muscle brightness and stiffness were similar (p>0.05). Inter-examiner reliability was good for determining the AS muscle stiffness (ICC = 0.881 for Young’s modulus and 0.850 for shear wave speed). Conclusion: The obtained results suggest that assessing the AS stiffness properties in asymptomatic subjects is a reliable procedure. Further studies should verify the SWE capacity for discriminating healthy and clinical populations and identify potential factors contributing to the variance of measurement errors.

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Quantitative Musculoskeletal Ultrasound

Cited by 10 publications

References 95 publications

Shear-wave elastography of the plantar fascia: a systematic review and meta-analysis

Shear-wave elastography of the plantar fascia: a systematic review and meta-analysis

Intraneural vascularity of the median, ulnar and common peroneal nerve: Microvascular ultrasound and pathophysiological implications

Reproducibility of Anterior Scalene Stiffness Measurement with Shear Wave Elastography: An Inter-Examiner Reliability Study

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