Ultrasound elastography in children: establishing the normal range of muscle elasticity
Netanel S Berko1, Erin F Fitzgerald, Terry D Amaral
1Department of Radiology, Montefiore Medical Center, 111 East 210th St., Bronx, NY, 10467, USA, nsberko@gmail.com.
Insights
Ultrasound elastography reveals differences in resting muscle elasticity in children, with significant increases post-exercise in biceps and rectus femoris muscles. Younger children show a greater elasticity change with exercise.
Area of Science:
- Pediatric Musculoskeletal Imaging
- Biomedical Ultrasound
- Tissue Mechanics
Background:
- Ultrasound elastography is a non-invasive technique to assess tissue elasticity.
- The elastographic characteristics of normal pediatric muscles have not been previously described.
Purpose of the Study:
- To characterize ultrasound (US) elasticity of pediatric muscles at rest.
- To evaluate changes in muscle elasticity following exercise in children.
Main Methods:
- Cine elastography was performed on the biceps brachii and rectus femoris muscles of 42 healthy children (aged 2-18 years).
- Muscles were assessed at rest and immediately after exercise.
- Elastography scores were assigned using a five-point color scale, and resting versus post-exercise scores were compared.
Main Results:
- Resting muscle elasticity was lower in the biceps brachii compared to the rectus femoris and in the non-dominant compared to the dominant biceps brachii.
- Post-exercise, muscle elasticity significantly increased in both muscle groups.
- Younger children exhibited a greater change in muscle elasticity with exercise.
Conclusions:
- Resting muscle elasticity in children differs between muscle groups and sides (dominant vs. non-dominant).
- Exercise significantly increases muscle elasticity in both biceps brachii and rectus femoris.
- The observed resting elasticity differences diminish after exercise, and younger children show more pronounced exercise-induced elasticity changes.
Background:
Ultrasound elastography allows assessment of tissue elasticity. To the best of our knowledge, the elastography appearance of muscles in normal children has not been described.
Objective:
To determine the US elasticity of muscles in children at rest and following exercise.
Materials And Methods:
Cine elastography of biceps brachii and rectus femoris muscles was obtained at rest and after exercise in 42 healthy children (23 males, 19 females; mean: 11.2 ± 4.4 years, range: 2-18 years). Elastography scores were assigned to each clip based on a five-point color scale. Mean elastography scores and standard deviations were calculated and resting and postexercise elastography scores were compared.
Results:
Resting muscle elasticity was lower in the biceps brachii than in the rectus femoris (P = 0.008), and higher in the dominant than in the nondominant biceps brachii (P < 0.032). Rectus femoris elasticity was higher in males than females (P = 0.051). Postexercise muscle elasticity significantly increased in both the dominant and nondominant biceps brachii (P < 0.001) and in the rectus femoris (P < 0.001). There was no significant gender-related difference in postexercise muscle elasticity. Biceps brachii elasticity decreased and rectus femoris elasticity increased with increasing body mass index. Younger subjects had a greater change in muscle elasticity with exercise.
Conclusion:
Resting muscle elasticity in children is significantly lower in the biceps brachii than in the rectus femoris and in the nondominant biceps brachii than in the dominant biceps brachii. Elasticity significantly increases immediately postexercise in both muscle groups; resting differences between biceps brachii and rectus femoris elasticity, and dominant and nondominant biceps brachii elasticity, do not persist after exercise. The change in muscle elasticity with exercise is higher in younger children.
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