Noninvasive Diagnosis of Chronic Exertional Compartment Syndrome With Shear Wave Elastography and Subharmonic Aided Pressure Estimation.

IF 2.4 4区医学 Q2 ACOUSTICS

Journal of Ultrasound in Medicine Pub Date : 2025-08-12 DOI:10.1002/jum.70030

Corinne E Wessner, Corbin Pomeranz, Rachel Blackman, Michael K Hoy, Kristen Bradigan, Stephen A Stache, Marc Harwood, Levon Nazarian, Flemming Forsberg

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引用次数: 0

Abstract

Objective: Chronic exertional compartment syndrome (CECS) is an underdiagnosed condition that affects young athletes. CECS is caused by increased compartmental pressure in the fascial spaces during exercise. CECS is diagnosed by direct pressure readings (in mmHg), which is a painful and invasive test. Noninvasive shear-wave elastography (SWE) and subharmonic-aided pressure estimation (SHAPE) using contrast-enhanced ultrasound were compared to compartment pressure testing for the diagnosis of CECS.

Methods: Ten healthy volunteers and five CECS patients enrolled in this prospective, IRB-approved pilot study. Subjects were scanned pre- and post-exercise using a modified LOGIQ E10 scanner (GE HealthCare). For SWE, muscle stiffness was expressed as median shear velocity over 12 measurements. Following intravenous infusion of Definity (3 mL in 50 mL of saline; Lantheus Medical Imaging) SHAPE power was optimized, and three 5-second clips were acquired. SWE and SHAPE pre-to-post differences were calculated offline and compared to CECS pressure testing (the reference).

Results: In the healthy volunteers, pre- versus post-exercise SWE showed a median velocity of 1.16 ± 0.17 versus 1.28 ± 0.22 m/s (P = .01). In the CECS patients, the difference was 1.11 ± 0.11 versus 1.41 ± 0.19 m/s (P = .06). However, there were no SWE differences between healthy volunteers and CECS patients (P = .14). For pre- and post-exercise SHAPE, both healthy volunteers and CECS patients demonstrated significant differences (-62.9 ± 2.09 vs -58.7 ± 2.74 dB and -59.0 ± 2.96 vs -50.8 ± 2.22 dB, respectively; P < .002). Healthy volunteers were statistically significantly different from CECS patients (4.2 ± 2.56 vs 8.1 ± 2.12 dB; P = .01). The SHAPE gradient correlated with compartment pressure testing (r = -0.95; P = .01).

Conclusions: These preliminary results indicate that SHAPE may become a noninvasive alternative for diagnosing CECS.

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用横波弹性成像和亚谐波辅助压力评估无创诊断慢性劳损室综合征。

目的：慢性运动室综合征（CECS）是一种未被诊断的疾病，影响着年轻运动员。ces是由运动时筋膜间隙室间压力增加引起的。CECS是通过直接压力读数（mmHg）诊断的，这是一种痛苦的侵入性检查。无创剪切波弹性成像（SWE）和亚谐波辅助压力估计（SHAPE）使用对比增强超声与室压试验诊断CECS进行比较。方法：10名健康志愿者和5名CECS患者参加了这项经irb批准的前瞻性试点研究。受试者在运动前和运动后使用改良的LOGIQ E10扫描仪（GE HealthCare）进行扫描。对于SWE，肌肉刚度表示为12次测量的中位剪切速度。静脉输注Definity (3ml加入50ml生理盐水中；对Lantheus Medical Imaging)的SHAPE电源进行优化，获得3个5秒的剪辑。离线计算SWE和SHAPE前后的差异，并与CECS压力测试（参考）进行比较。结果：在健康志愿者中，运动前和运动后SWE的中位速度分别为1.16±0.17和1.28±0.22 m/s （P = 0.01）。在CECS患者中，差异为1.11±0.11和1.41±0.19 m/s （P = 0.06）。然而，健康志愿者和CECS患者之间没有SWE差异（P = .14）。对于运动前和运动后的SHAPE，健康志愿者和CECS患者表现出显著差异（分别为-62.9±2.09 vs -58.7±2.74 dB和-59.0±2.96 vs -50.8±2.22 dB）；结论：这些初步结果表明SHAPE可能成为诊断CECS的无创替代方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Ultrasound in Medicine 医学-核医学

CiteScore

5.10

自引率

4.30%

发文量

205

审稿时长

1.5 months

期刊介绍： The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound