Relationship of Skeletal Muscle Perfusion Measured by Contrast-Enhanced Ultrasonography to Histologic Microvascular Density

Weber, Marc‐André; Krakowski-Roosen, Holger; Delorme, Stefan; Renk, Hanna; Krix, Martin; Millies, Juan; Kinscherf, Ralf; Künkele, Annette; Kauczor, Hans‐Ulrich; Hildebrandt, Wulf

doi:10.7863/jum.2006.25.5.583

Cited by 55 publications

(49 citation statements)

References 28 publications

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“…This technique is sensitive enough to allow for detection of the low skeletal muscle perfusion, i.e. the capillary blood flow, at rest [11]. It also allows for quantification of physiologically increased perfusion after exercise [9] and pathologically increased perfusion in inflammatory myopathies [10].…”

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Morphology, metabolism, microcirculation, and strength of skeletal muscles in cancer-related cachexia

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Morphology, metabolism, microcirculation, and strength of skeletal muscles in cancer-related cachexia

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“…[1][2][3][4][5][6][7][8] This increase in blood flow is proportional to the metabolic demands of the muscle tissue being exercised. 9 Metabolic demand changes depending on the type of exercise performed.…”

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Microvascular Perfusion Increases After Eccentric Exercise of the Gastrocnemius

Selkow

Herman

Liu

et al. 2013

Journal of Ultrasound in Medicine

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epeated contractions of skeletal muscle, as in exercise, have been shown to increase local blood flow. [1][2][3][4][5][6][7][8] This increase in blood flow is proportional to the metabolic demands of the muscle tissue being exercised. 9 Metabolic demand changes depending on the type of exercise performed. Eccentric contractions produce more force with less metabolic demand than concentric or isometric contractions. 10 It is unclear, however, whether this difference in metabolic demand alters circulatory responses in muscle as seen with concentric-eccentric and isometric contractions. During eccentric contractions, the breakdown of adenosine triphosphate is slowed, resulting in lower requirements for energy 11,12 and oxygen consumption to rarely elevate from rest. 13,14 Several studies have examined the effect of isometric or concentriceccentric contractions on blood flow. 2-8 However, eccentric-only Noelle M. Selkow, PhD, ATC, Daniel C. Herman, MD, PhD, Zhenqi Liu, MD, Jay Hertel, PhD, ATC, Joseph M. Hart, PhD, ATC, Susan A. Saliba, PhD, MPT, ATC Received July 13, 2012, ORIGINAL RESEARCHObjectives-The purpose of this study was to assess microvascular perfusion immediately after eccentric exercise using contrast-enhanced sonography.Methods-An intravenous catheter was placed in the antecubital vein of the arm contralateral to the leg being tested for the delivery of microbubbles to 18 healthy volunteers (mean age ± SD, 22.2 ± 2.2 years; height, 166.0 ± 11.9 cm; weight, 69.4 ± 25.0 kg). Eccentric exercises were performed unilaterally in a randomized leg. Calf-lowering repetitions off a raised step were performed to the beat of a metronome over 3 seconds in the sequence of 50 repetitions, 5 minutes of rest, and 50 repetitions. Microvascular perfusion (blood volume, blood flow, and blood flow velocity) was measured before and immediately after exercise using replenishment kinetics.Results-Blood volume and flow both significantly increased after exercise (P < .001). Baseline measurements were 5.88 ± 1.33 dB and 2.34 ± 0.41 dB/s and increased to 12.20 ± 3.31 dB and 4.52 ± 1.05 dB/s, respectively. There was a significant decrease in blood flow velocity (P = .035) after exercise (0.38 ± 0.03 s -1 ) from baseline (0.41 ± 0.06 s -1 ).Conclusions-Circulatory responses were altered after eccentric exercise, which may be due to the metabolic demand placed on the body. On the basis of this finding, eccentric exercise may be used as a model to assess the effect modalities have on the circulatory system after an elevated state of microvascular perfusion is reached.

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“…Whether persistence of the Doppler signal over time suggests a longer recovery period may warrant evaluation. Contrastenhanced sonography has been reported to improve the evaluation of muscle blood flow 20 and acute muscle injury, 21 but in our experience, contrast-enhanced sonography did not substantially improve the assessment of acute muscle injuries.…”

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Value of Sonography Combined With Clinical Assessment to Evaluate Muscle Injury Severity in Athletes

Guillodo

Bouttier

Saraux

2011

Journal of Athletic Training

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Context:Predicting when an athlete can return to sport after muscle injury is a major concern.Objective: To determine whether combining objective clinical and ultrasound findings at presentation accurately predicted time to sport resumption in athletes with muscle injuries.Design: Cohort study. Setting: Sports medicine clinic. Patients or Other Participants: A total of 93 consecutive patients, 87 male and 6 female, were seen over a 1-year period for sudden-onset muscle pain while engaging in a sporting activity within the last 5 days and inability to continue the training session or game. Intervention(s): Standardized physical examination and sonogram.Main Outcome Measure(s): Statistical associations between clinical and sonographic features at presentation and time to sport resumption (<40 days or ≥40 days) were evaluated using multivariate models. Correlations between time to sport resumption predicted by a sports medicine specialist and actual time to sport resumption were evaluated using the Spearman rank correlation coefficient.Results: The 93 patients had 95 injuries, caused by muscle contraction in 86 cases and impact in 9 cases. Only 7 injuries had normal sonogram findings. Late sport resumption was associated with 4 clinical criteria (bruising, tenderness to palpation, range-of-motion limitation compared with the other limb, and increased pain with isometric contraction during passive limb straightening) and 4 sonographic criteria (disorganized fibrous tissue, intramuscular hematoma, intermuscular hematoma, and power Doppler signal). The Spearman rank correlation coefficient between predicted and actual times was 0.669 (P < .0001) for mild exercise resumption and 0.804 (P < .0001) for full sport resumption.Conclusion: A combination of physical and sonographic data collected during the acute phase of sport-related muscle injury was effective in predicting time to sport resumption.Key Words: diagnostic imaging, contusions, strains, sports, return to sport Key Points• Sonography was useful for diagnosing acute sport-related muscle injuries, monitoring the course of the injuries, and guiding the drainage of fluid if needed.• In combination with the objective physical findings, sonographic findings were beneficial in predicting injury severity and time to resumption of sport.

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Relationship of Skeletal Muscle Perfusion Measured by Contrast-Enhanced Ultrasonography to Histologic Microvascular Density

Abstract: B is significantly related to fiber-adjacent capillarization and may represent physiologic capillary recruitment (eg, through metabolic fiber-related signals). CEUS is feasible for skeletal muscle perfusion quantification.

Cited by 55 publications

References 28 publications

Morphology, metabolism, microcirculation, and strength of skeletal muscles in cancer-related cachexia

Morphology, metabolism, microcirculation, and strength of skeletal muscles in cancer-related cachexia

Microvascular Perfusion Increases After Eccentric Exercise of the Gastrocnemius

Value of Sonography Combined With Clinical Assessment to Evaluate Muscle Injury Severity in Athletes

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