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Updated: May 12, 2026
A Novel Non-invasive Method for the Detection of Elevated Intra-compartmental Pressures of the Leg
Published on: May 31, 2019
Quantitation of Acute Extremity Compartment Syndrome in Rabbits Using Shear-wave Elastography to Assess
Xiaobo Ren1, Yiqing Zhang1, Peng Zhai2
1Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Medical School, Shenzhen University, 518060, China (X.R., Y.Z., X.C., M.L.).
Rationale And Objectives:
Acute extremity compartment syndrome (AECS) lacks reliable noninvasive diagnostics. This study aimed to validate shear-wave elastography-derived viscoelastic parameters for assessing muscle pathology progress in a rabbit AECS model.
Methods:
Forty-eight New Zealand rabbits were randomized into eight groups (control, 4, 6, 8, 12, 24, 48, and 72 h post-procedure; n = 6). AECS was induced via ultrasound-guided femoral artery hypoperfusion (75% flow reduction) and calf cuff compression (200 mmHg, 2 h). Shear-wave speed (SWS) and viscosity (η) of the triceps surae muscle were measured using a programmable ultrasound, with intra-compartmental pressure (ICP) monitored concurrently. Histopathological grading (HGS: 0-9 scale) and ultrastructural staging (USS: 0-4 scale) were performed on hematoxylin and eosin (H&E) or transmission electron microscope (TEM) sections. Apoptosis (TUNEL apoptotic index) and systemic inflammation (plasma TNF-α) were quantified.
Results:
Histology showed inflammatory cell infiltration, interstitial edema, necrosis, and microenvironmental degeneration in model limbs. HGS strongly correlated with SWS (r = 0.693) and η (r = 0.710, both p < 0.001). η was strongly associated with TNF-α (r = 0.702) and necrosis (r = 0.722), while SWS weakly correlated with inflammation (r = 0.345, p = 0.029). Receiver operating characteristic (ROC) analysis revealed η outperformed SWS in lesions detection (AUC: 0.894 [95% CI: 0.832-0.955] vs. 0.829 [0.749-0.908], p > 0.05). Combined SWS-η metrics improved diagnostic accuracy (AUC = 0.905 [0.845-0.965], p = 0.007 vs. SWS alone).
Conclusion:
SWS and η effectively quantify necrosis and inflammation in AECS progression and offer potential for noninvasive, continuous monitoring.
