Magnetic resonance elastography of skeletal muscle deep tissue injury

Jules L. Nelissen (Corresponding author), Ralph Sinkus, Klaas Nicolay, Aart J. Nederveen, Cees W.J. Oomens, Gustav J. Strijkers

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Abstract

The current state-of-the-art diagnosis method for deep tissue injury in muscle, a subcategory of pressure ulcers, is palpation. It is recognized that deep tissue injury is frequently preceded by altered biomechanical properties. A quantitative understanding of the changes in biomechanical properties preceding and during deep tissue injury development is therefore highly desired. In this paper we quantified the spatial–temporal changes in mechanical properties upon damage development and recovery in a rat model of deep tissue injury. Deep tissue injury was induced in nine rats by two hours of sustained deformation of the tibialis anterior muscle. Magnetic resonance elastography (MRE), T 2 -weighted, and T 2 -mapping measurements were performed before, directly after indentation, and at several timepoints during a 14-day follow-up. The results revealed a local hotspot of elevated shear modulus (from 3.30 ± 0.14 kPa before to 4.22 ± 0.90 kPa after) near the center of deformation at Day 0, whereas the T 2 was elevated in a larger area. During recovery there was a clear difference in the time course of the shear modulus and T 2 . Whereas T 2 showed a gradual normalization towards baseline, the shear modulus dropped below baseline from Day 3 up to Day 10 (from 3.29 ± 0.07 kPa before to 2.68 ± 0.23 kPa at Day 10, P < 0.001), followed by a normalization at Day 14. In conclusion, we found an initial increase in shear modulus directly after two hours of damage-inducing deformation, which was followed by decreased shear modulus from Day 3 up to Day 10, and subsequent normalization. The lower shear modulus originates from the moderate to severe degeneration of the muscle. MRE stiffness values were affected in a smaller area as compared with T 2 . Since T 2 elevation is related to edema, distributing along the muscle fibers proximally and distally from the injury, we suggest that MRE is more specific than T 2 for localization of the actual damaged area.

Original languageEnglish
Article numbere4087
Number of pages12
JournalNMR in Biomedicine
Volume32
Issue number6
Early online date1 Jan 2019
DOIs
Publication statusPublished - Jun 2019

Fingerprint

Elasticity Imaging Techniques
Magnetic resonance
Muscle
Skeletal Muscle
Elastic moduli
Tissue
Muscles
Wounds and Injuries
Rats
Recovery
Pressure Ulcer
Palpation
Indentation
Edema
Stiffness
Mechanical properties
Fibers

Keywords

  • biomechanical properties
  • deep tissue injury
  • magnetic resonance elastography
  • MRI
  • muscle damage
  • pressure wound
  • skeletal pressure ulcer

Cite this

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title = "Magnetic resonance elastography of skeletal muscle deep tissue injury",
abstract = "The current state-of-the-art diagnosis method for deep tissue injury in muscle, a subcategory of pressure ulcers, is palpation. It is recognized that deep tissue injury is frequently preceded by altered biomechanical properties. A quantitative understanding of the changes in biomechanical properties preceding and during deep tissue injury development is therefore highly desired. In this paper we quantified the spatial–temporal changes in mechanical properties upon damage development and recovery in a rat model of deep tissue injury. Deep tissue injury was induced in nine rats by two hours of sustained deformation of the tibialis anterior muscle. Magnetic resonance elastography (MRE), T 2 -weighted, and T 2 -mapping measurements were performed before, directly after indentation, and at several timepoints during a 14-day follow-up. The results revealed a local hotspot of elevated shear modulus (from 3.30 ± 0.14 kPa before to 4.22 ± 0.90 kPa after) near the center of deformation at Day 0, whereas the T 2 was elevated in a larger area. During recovery there was a clear difference in the time course of the shear modulus and T 2 . Whereas T 2 showed a gradual normalization towards baseline, the shear modulus dropped below baseline from Day 3 up to Day 10 (from 3.29 ± 0.07 kPa before to 2.68 ± 0.23 kPa at Day 10, P < 0.001), followed by a normalization at Day 14. In conclusion, we found an initial increase in shear modulus directly after two hours of damage-inducing deformation, which was followed by decreased shear modulus from Day 3 up to Day 10, and subsequent normalization. The lower shear modulus originates from the moderate to severe degeneration of the muscle. MRE stiffness values were affected in a smaller area as compared with T 2 . Since T 2 elevation is related to edema, distributing along the muscle fibers proximally and distally from the injury, we suggest that MRE is more specific than T 2 for localization of the actual damaged area.",
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Magnetic resonance elastography of skeletal muscle deep tissue injury. / Nelissen, Jules L. (Corresponding author); Sinkus, Ralph; Nicolay, Klaas; Nederveen, Aart J.; Oomens, Cees W.J.; Strijkers, Gustav J.

In: NMR in Biomedicine, Vol. 32, No. 6, e4087, 06.2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Magnetic resonance elastography of skeletal muscle deep tissue injury

AU - Nelissen, Jules L.

AU - Sinkus, Ralph

AU - Nicolay, Klaas

AU - Nederveen, Aart J.

AU - Oomens, Cees W.J.

AU - Strijkers, Gustav J.

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N2 - The current state-of-the-art diagnosis method for deep tissue injury in muscle, a subcategory of pressure ulcers, is palpation. It is recognized that deep tissue injury is frequently preceded by altered biomechanical properties. A quantitative understanding of the changes in biomechanical properties preceding and during deep tissue injury development is therefore highly desired. In this paper we quantified the spatial–temporal changes in mechanical properties upon damage development and recovery in a rat model of deep tissue injury. Deep tissue injury was induced in nine rats by two hours of sustained deformation of the tibialis anterior muscle. Magnetic resonance elastography (MRE), T 2 -weighted, and T 2 -mapping measurements were performed before, directly after indentation, and at several timepoints during a 14-day follow-up. The results revealed a local hotspot of elevated shear modulus (from 3.30 ± 0.14 kPa before to 4.22 ± 0.90 kPa after) near the center of deformation at Day 0, whereas the T 2 was elevated in a larger area. During recovery there was a clear difference in the time course of the shear modulus and T 2 . Whereas T 2 showed a gradual normalization towards baseline, the shear modulus dropped below baseline from Day 3 up to Day 10 (from 3.29 ± 0.07 kPa before to 2.68 ± 0.23 kPa at Day 10, P < 0.001), followed by a normalization at Day 14. In conclusion, we found an initial increase in shear modulus directly after two hours of damage-inducing deformation, which was followed by decreased shear modulus from Day 3 up to Day 10, and subsequent normalization. The lower shear modulus originates from the moderate to severe degeneration of the muscle. MRE stiffness values were affected in a smaller area as compared with T 2 . Since T 2 elevation is related to edema, distributing along the muscle fibers proximally and distally from the injury, we suggest that MRE is more specific than T 2 for localization of the actual damaged area.

AB - The current state-of-the-art diagnosis method for deep tissue injury in muscle, a subcategory of pressure ulcers, is palpation. It is recognized that deep tissue injury is frequently preceded by altered biomechanical properties. A quantitative understanding of the changes in biomechanical properties preceding and during deep tissue injury development is therefore highly desired. In this paper we quantified the spatial–temporal changes in mechanical properties upon damage development and recovery in a rat model of deep tissue injury. Deep tissue injury was induced in nine rats by two hours of sustained deformation of the tibialis anterior muscle. Magnetic resonance elastography (MRE), T 2 -weighted, and T 2 -mapping measurements were performed before, directly after indentation, and at several timepoints during a 14-day follow-up. The results revealed a local hotspot of elevated shear modulus (from 3.30 ± 0.14 kPa before to 4.22 ± 0.90 kPa after) near the center of deformation at Day 0, whereas the T 2 was elevated in a larger area. During recovery there was a clear difference in the time course of the shear modulus and T 2 . Whereas T 2 showed a gradual normalization towards baseline, the shear modulus dropped below baseline from Day 3 up to Day 10 (from 3.29 ± 0.07 kPa before to 2.68 ± 0.23 kPa at Day 10, P < 0.001), followed by a normalization at Day 14. In conclusion, we found an initial increase in shear modulus directly after two hours of damage-inducing deformation, which was followed by decreased shear modulus from Day 3 up to Day 10, and subsequent normalization. The lower shear modulus originates from the moderate to severe degeneration of the muscle. MRE stiffness values were affected in a smaller area as compared with T 2 . Since T 2 elevation is related to edema, distributing along the muscle fibers proximally and distally from the injury, we suggest that MRE is more specific than T 2 for localization of the actual damaged area.

KW - biomechanical properties

KW - deep tissue injury

KW - magnetic resonance elastography

KW - MRI

KW - muscle damage

KW - pressure wound

KW - skeletal pressure ulcer

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