Muscle shear wave elastography in idiopathic inflammatory myopathies: a case–control study with MRI correlation

Abstract

Objective To investigate muscle stiffness in patients with idiopathic inflammatory myopathies (IIM) using shear wave elastography (SWE) and to correlate the results with muscle strength and MRI features of myositis. Materials and methods Muscle shear wave velocity (SWV) was measured in 23 active IIM patients (13 females, mean age 50.4 ± 16.1 years) and 23 matched healthy controls (13 females, mean age 50.7 ± 16.2 years). The investigated muscles included the vastus lateralis (VL), rectus femoris (RF), vastus medialis (VM) vastus intermedius (VI), biceps femoris (BF), semitendinosus (ST), semimembranosus (SM) and the biceps brachii (BB) scanned during relaxed resting and passive stretching positions. Participants performed multiple tests to evaluate their muscle strength. IIM patients had a thigh MRI to assess degrees of oedema, fatty infiltration and atrophy. Results In the resting position, IIM patients had a 12.9–22.2% significantly lower SWV ( p < 0.05) for the quadriceps and hamstrings, but not BB. There was no difference during passive stretching. The SWV for VL, VI and BF showed moderate correlations with the muscle strength tests ranging from r = 0.47 to r = 0.70 (all p < 0.05). Lower SWV was associated with greater MRI scores of oedema ( p = 0.001) and atrophy ( p = 0.006). However, SWV did not correlate with fatty infiltration ( r < 0.3; p = 0.28), creatine kinase ( r = 0.28; p = 0.19) or disease duration ( r = 0.26; p = 0.24). Conclusion Shear wave elastography may detect abnormal reduced thigh stiffness in IIM patients. SWE measurements were significantly associated with muscle weakness and MRI signs of oedema and atrophy. Future research should investigate this new technology for monitoring disease activity. Electronic supplementary material The online version of this article (10.1007/s00256-019-03175-3) contains supplementary material, which is available to authorized users

Diagnostic Value of Muscle Ultrasound for Myopathies and Myositis

“…Lower muscle stiffness was seen to be associated with more severe weakness, and the technique was found to be feasible and reliable (satisfactory within-day and moderate between-day reliability). In another study looking at 23 active myositis patients and comparing this with healthy controls, reduced muscle stiffness was also detected particularly at the thighs [60]. SWE was significantly associated with muscle weakness and MRI signs of edema and atrophy, but not with fat infiltration, CPK levels, or disease duration.…”

Novel Muscle Imaging in Inflammatory Rheumatic Diseases—A Focus on Ultrasound Shear Wave Elastography and Quantitative MRI

“…Nevertheless, the current evidence suggests that SWE shows less muscle stiffness in myositis compared to healthy individuals ( Figure 3 ), and can distinguish myositis from normal muscles ( 86 ). The loss of muscle stiffness in myositis patients was also observed using magnetic resonance elastography ( 87 ).…”

Reduction in stiffness of proximal leg muscles during the first 6 months of glucocorticoid therapy for giant cell arteritis: A pilot study using shear wave elastography

“…The machine then sends tracking waves to detect the velocity of the shear waves in meters/second (m/s), which can be used as a surrogate for tissue stiffness . The muscle SWE acquisition technique was adapted from our previous work . The probe was oriented along the muscle fibers and placed with minimal load on skin to avoid causing tissue deformation.…”

“…12 The muscle SWE acquisition technique was adapted from our previous work. [21][22][23] The probe was oriented along the muscle fibers and placed with minimal load on skin to avoid causing tissue deformation. and semimembranosus [SM]) and the biceps brachii (BB).…”