Abstract
Purpose
The aim of this study is to quantitatively assess lower limbs muscle elasticity in a court of healthy subjects and to evaluate the influence of technical variables (e.g., diameter of the ROI—region of interest) and examined subjects’ characteristics (e.g., sex, levels of physical activity, side evaluated) on muscle stiffness.
Materials and methods
54 healthy subjects (48 men, 6 women) were evaluated for a total of 108 lower limbs. Shear wave elastography was performed with a multifrequency linear probe (15–4 MHz). Two radiologists performed the evaluation of lower limbs from left to right side (first calf and then thigh). The measures were taken on gastrocnemius and on femoral biceps muscle belly. We chose to place for this study two ROIs of 4 and 2 mm of diameter.
Results
The mean muscle stiffness was 1.98 ± 0.48 (range between 1.89 ± 0.36 and 2.15 ± 0.57 m/s). The difference in muscle stiffness between left and right side of the body and between different levels of physical activity never became statistically significant (p value between 0.314 and 0.915). Only in one test out of eight the difference of muscle stiffness between male and female resulted statistically significant (p value 0.020). When comparing the measurement obtained with a 2 and 4 mm diameter ROIs the values were statistically different only for the left thigh (p value 0.028).
Conclusion
Our study, despite its limitations (low sample and low female population), seems to give some clear advice: physiological or technical factors do not determine statistically significant differences on passive muscle stiffness.
Sommario
Scopo
lo scopo del nostro studio è quello di valutare quantitativamente l’elasticità dei muscoli degli arti inferiori in una coorte di soggetti sani e di valutare l’influenza di variabili tecniche (ad esempio il diametro della regione di interesse) e delle caratteristiche dei soggetti esaminati (ad esempio il livello di attività fisica, il lato valutato) sulla stiffness muscolare.
Materiali e metodi
sono stati valutati 54 soggetti sani (48 uomini e 6 donne) per un totale di 108 arti inferiori. L’elastografia Shear Wave è stata realizzata con sonda lineare multifrequenza (15–4 MHz). Due radiologi hanno realizzato la valutazione degli arti inferiori da sinistra a destra (prima il polpaccio e poi la coscia). Le misure sono state realizzate sui ventri muscolari del gastrocnemio e del bicipite femorale. Per questo studio si è deciso di posizionare 2 ROI (regioni di interesse) di 2 e 4 mm di diametro.
Risultati
L’elasticità media muscolare rilevata è di 1,98 ± 0,48 m/s (valori compresi tra 1,89 ± 0,36 e 2,15 ± 0,57 m/s). La differenza nella stiffness muscolare tra lato sinistro e destro del corpo e per diversi livelli di attività fisica non è mai diventata statisticamente significativa (p value compresi tra 0,314 e 0,915). Solo in un test statistico su otto la differenza nella stiffness muscolare tra uomini e donne è risultata statisticamente significativa (p value 0,020). Nella comparazione tra valori ottenuti con le ROI da 2 e 4 mm la differenza è risultata statisticamente significativa solo per la coscia di sinistra (p value 0,028).
Conclusioni
il nostro studio, nonostante le sue limitazioni (come il campione ridotto e la scarsa rappresentazione della popolazione femminile), sembra fornire alcune indicazioni: i fattori tecnici e fisiologici non sembrano essere in grado di determinare differenze statisticamente significative della stiffness muscolare passiva.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki declaration of 1975, as revised in 2000.
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The patient provided written informed consent to enrolment in the study and to the publication of information that could potentially lead to his identification.
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Bortolotto, C., Lungarotti, L., Fiorina, I. et al. Influence of subjects’ characteristics and technical variables on muscle stiffness measured by shear wave elastosonography. J Ultrasound 20, 139–146 (2017). https://doi.org/10.1007/s40477-017-0242-9
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DOI: https://doi.org/10.1007/s40477-017-0242-9