Clinical implications of basic researchUltrasound Elastography: The New Frontier in Direct Measurement of Muscle Stiffness
Section snippets
Ultrasound elastography principles and techniques
In general, all methods-testing techniques for determining the material properties of tissue, including mechanical properties, involve measurements of deformation in response to applied stress or force. Ultrasound elastography relies on the same principle. The stress can be produced by internal physiological motions (eg, beating of the heart,18, 19 pulsation of a blood vessel20), external mechanical compression or vibration,21, 22, 23 or a high-intensity long-duration (hundreds of ultrasound
Ultrasound elastography and muscle
Both passive and active muscle stiffness contribute to physical function. The measurement of passive and active stiffness of individual muscles is challenging because common techniques used for musculoskeletal measurements are not capable of measuring individual muscles in isolation. These techniques are gross measurements of the entire joint, muscle, tendon, or neurovascular complex. However, certain conditions (eg, muscular dystrophy, collagen disorders, cerebral palsy, prolonged bed rest,
Future directions
The real-time, direct measurement of the passive and active properties of individual muscles has already begun to advance our basic understanding of skeletal muscle. Improvements in the rehabilitation of patients with these conditions can be expected with greater understanding of the relation between muscle properties and physical function. As this technology and these muscle measurements are being explored, questions remain regarding the measurement capabilities of ultrasound elastography. How
Conclusions
As ultrasound elastography evolves, we must strive to understand its varied techniques, including its strengths, limitations, and anticipated clinical applications for use in muscle measurements. Ultrasound elastography provides the opportunity to further our understanding of the interaction between muscle structure and function by its measurement of individual muscle mechanical properties. Direct measurement has the potential to quantify previously subjective clinical examination measurements
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Supported in part by the National Institutes of Health (grant no. KL2TR000136-07); Department of Physical Medicine and Rehabilitation at Mayo Clinic, Rochester, Minnesota; and National Institutes of Health through grants from the National Institute on Aging (grant no. F30 AG044075) and National Institute of General Medical Sciences (grant no. T32 GM 65841).
Disclosures: Zhao, Chen, and Song disclose royalties from General Electric Medical Systems and Samsung Electronics Company Ltd for ultrasound elastography technology. Chen receives consultation fees from Sonoscape Inc. The authors disclose the following patents: Zhao and Chen: System and Method for Correcting Errors in Shear Wave Measurements Arising from Ultrasound Beam Geometry (patent no. 8,734,350); Chen: Vibration Generation and Detection in Shear Wave Dispersion Ultrasound Vibrometry with Large Background Motions (patent no. 8,659,975), Method for Ultrasound Vibrometry using Orthogonal Basis Functions (patent no. 8,602,994), Detection of Motion in Vibro-Acoustography (patent no. 7,785,259), Ultrasound Vibrometry (patent no. 7,753,847), Method and Apparatus for Shear Property Characterization from Resonance Induced by Oscillatory Radiation Force (patent no. 7,713,201); An: Expandable Screw Apparatus and Method (patent no. 6,668,688), Spinal Fixation Support Device and Methods of Using (patent no. 7,060,066), Temporomandibular Joint Fossa-Eminence Prosthesis (patent no. 8,211,180), and Doppler Ultrasound for Identifying Material Properties of a Carpal Tunnel Anatomy (patent no. 8,216,148). The other authors have nothing to disclose.