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Ultrasonic Quantification of Skeletal Muscle Dynamics: Feasibility and Limitations
KTH, School of Technology and Health (STH), Medical Engineering.
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Pain and disorders of the human skeletal muscles are one of the most common reasons for medical consultations in the western countries today and there is a great need to improve both the understanding and treatment of several different muscular conditions.

Techniques describing the muscle function in vivo are often limited by either their invasiveness or lack of spatial resolution. Electromyography (EMG) is the most common approach to assess the skeletal muscle function in vivo, providing information on the neurological input. However, the spatial resolution is in general limited and there are difficulties reaching deep musculature without using invasive needles. Moreover, it does not provide any information about muscle structure or mechanical aspects.

Quantitative ultrasound techniques have gained interest in the area of skeletal muscles and enables non-invasive and in-vivo insight to the intramuscular activity, through the mechanical response of the activation. However, these techniques are developed and evaluated for cardiovascular applications and there are important considerations to be made when applying these methods in the musculoskeletal field. 

This thesis is based on the work from four papers with the main focus to investigate and describe some of these considerations in combination with the development of processing and analyzing methods that can be used to describe the physiological characteristics of active muscle tissue.

In the first paper the accuracy of the Doppler based technique Tissue Velocity Imaging (TVI) was evaluated in a phantom study for very low tissue velocities and the effect of the pulse repetition frequency was considered. The second paper presents a biomechanical model to describe the TVI strain’s dependency on the muscle fiber pennation angle. In the third and fourth papers the intramuscular activity pattern was assessed through the regional tissue deformation by motion mode (M-mode) strain imaging. The activity patterns were analyzed during force regulation and for the effects of fatigue.

The work of this thesis show promising results for the application of these methods on skeletal muscles and indicate high clinical potential where quantitative ultrasound may be a valuable tool to reach a more multifaceted and comprehensive insight in the musculoskeletal function. However, the methodological considerations are highly important for the optimized application and further evaluation and development of analyzing strategies are needed.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2013. , x, 54 p.
Series
Trita-STH : report, ISSN 1653-3836 ; 2013:4
Keyword [en]
ultrasound, skeletal muscle, intramuscular, dynamics, Tissue Doppler Imaging, Speckle Tracking, strain, quantification
National Category
Medical Image Processing
Identifiers
URN: urn:nbn:se:kth:diva-122233ISBN: 978-91-7501-737-2 (print)OAI: oai:DiVA.org:kth-122233DiVA: diva2:621434
Public defence
2013-06-05, sal 3-221, Alfred Nobels Allé 10, Huddinge, 13:00 (Swedish)
Opponent
Supervisors
Note

QC 20130516

Available from: 2013-05-16 Created: 2013-05-14 Last updated: 2013-05-16Bibliographically approved
List of papers
1. Evaluation of ultrasound Tissue Velocity Imaging: a phantom study of velocity estimation in skeletal muscle low-level contractions
Open this publication in new window or tab >>Evaluation of ultrasound Tissue Velocity Imaging: a phantom study of velocity estimation in skeletal muscle low-level contractions
2013 (English)In: BMC Medical Imaging, ISSN 1471-2342, E-ISSN 1471-2342, Vol. 13, no 1, 16- p.Article in journal (Refereed) Published
Abstract [en]

Background: Tissue Velocity Imaging (TVI) is an ultrasound based technique used for quantitative analysis of the cardiac function and has earlier been evaluated according to myocardial velocities. Recent years several studies have reported applying TVI in the analysis of skeletal muscles. Skeletal tissue velocities can be very low. In particular, when performing isometric contractions or contractions of low force level the velocities may be much lower compared to the myocardial tissue velocities. Methods: In this study TVI was evaluated for estimation of tissue velocities below the typical myocardial velocities. An in-house phantom was used to see how different PRF-settings affected the accuracy of the velocity estimations. Results: With phantom peak velocity at 0.03 cm/s the error ranged from 31% up to 313% with the different PRF-settings in this study. For the peak velocities at 0.17 cm/s and 0.26 cm/s there was no difference in error with tested PFR settings, it is kept approximately around 20%. Conclusions: The results from the present study showed that the PRF setting did not seem to affect the accuracy of the velocity estimation at tissue velocities above 0.17 cm/s. However at lower velocities (0.03 cm/s) the setting was crucial for the accuracy. The PRF should therefore preferable be reduced when the method is applied in low-level muscle contraction.

Place, publisher, year, edition, pages
BioMed Central, 2013
Keyword
Tissue Velocity Imaging, Ultrasound, Skeletal muscle, Phantom evaluation, Pulse repetition frequency
National Category
Medical Engineering
Identifiers
urn:nbn:se:kth:diva-122231 (URN)10.1186/1471-2342-13-16 (DOI)000321369400001 ()2-s2.0-84878629040 (Scopus ID)
Note

QC 20130805. Updated from submitted to published.

Available from: 2013-05-14 Created: 2013-05-14 Last updated: 2017-12-06Bibliographically approved
2. Pennation angle dependency in skeletal muscle tissue doppler strain in dynamic contractions
Open this publication in new window or tab >>Pennation angle dependency in skeletal muscle tissue doppler strain in dynamic contractions
Show others...
2011 (English)In: Ultrasound in Medicine and Biology, ISSN 0301-5629, E-ISSN 1879-291X, Vol. 37, no 7, 1151-1160 p.Article in journal (Refereed) Published
Abstract [en]

Tissue velocity imaging (TVI) is a Doppler based ultrasound technique that can be used to study regional deformation in skeletal muscle tissue. The aim of this study was to develop a biomechanical model to describe the TVI strain's dependency on the pennation angle. We demonstrate its impact as the subsequent strain measurement error using dynamic elbow contractions from the medial and the lateral part of biceps brachii at two different loadings; 5% and 25% of maximum voluntary contraction (MVC). The estimated pennation angles were on average about 4 degrees in extended position and increased to a maximal of 13 degrees in flexed elbow position. The corresponding relative angular error spread from around 7% up to around 40%. To accurately apply TVI on skeletal muscles, the error due to angle changes should be compensated for. As a suggestion, this could be done according to the presented model.

Keyword
Ultrasound, Tissue Doppler, Skeletal muscle, Pennation angle, Strain, Biceps brachii
National Category
Medical Laboratory and Measurements Technologies
Identifiers
urn:nbn:se:kth:diva-35598 (URN)10.1016/j.ultrasmedbio.2011.04.006 (DOI)000291716100014 ()2-s2.0-79959208321 (Scopus ID)
Funder
Swedish Research Council, 2007-3959
Note

QC 20110706

Available from: 2011-07-06 Created: 2011-07-04 Last updated: 2017-12-11Bibliographically approved
3. Assessment of intramuscular activation patterns using ultrasound M-mode strain
Open this publication in new window or tab >>Assessment of intramuscular activation patterns using ultrasound M-mode strain
2013 (English)In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 23, no 4, 879-885 p.Article in journal (Refereed) Published
Abstract [en]

The intramuscular activation pattern can be connected to the motor unit recruitment strategy of force generation and fatigue resistance. Electromyography has earlier been used in several studies to quantify the spatial inhomogeneity of the muscle activation. We applied ultrasound M-mode strain to study the activation pattern through the tissue deformation. Correlation values of the strain at different force levels were used to quantify the spatial changes in the activation. The assessment was done including the biceps brachii muscle of 8 healthy subjects performing isometric elbow flexion contractions ranging from 0% to 80% of maximum voluntary contraction. The obtained results were repeatable and demonstrated consistent changes of the correlation values during force regulation, in agreement with previously presented EMG-results. Both intra-subject and inter-subject activation patterns of strain were considered along and transverse the fiber direction. The results suggest that ultrasound M-mode strain can be used as a complementary method to study intramuscular activation patterns with high spatial resolution.

Place, publisher, year, edition, pages
Elsevier, 2013
Keyword
Intramuscular activation, Recruitment strategies, Ultrasound, Strain, Biceps brachii
National Category
Medical Engineering
Identifiers
urn:nbn:se:kth:diva-122176 (URN)10.1016/j.jelekin.2013.02.011 (DOI)000321107900019 ()23557977 (PubMedID)2-s2.0-84879550657 (Scopus ID)
Funder
Swedish Research Council, VR 2007-3959
Note

QC 20130812

Available from: 2013-05-14 Created: 2013-05-14 Last updated: 2017-04-28Bibliographically approved
4. Biceps brachii activity pattern during repetitive elbow flexions using ultrasound strain: effect of fatigue
Open this publication in new window or tab >>Biceps brachii activity pattern during repetitive elbow flexions using ultrasound strain: effect of fatigue
Show others...
(English)Manuscript (preprint) (Other academic)
National Category
Medical Engineering
Identifiers
urn:nbn:se:kth:diva-122232 (URN)
Note

QS 2013

Available from: 2013-05-14 Created: 2013-05-14 Last updated: 2013-05-16Bibliographically approved

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