Pediatric Radiology

, Volume 44, Issue 2, pp 158–163

Ultrasound elastography in children: Establishing the normal range of muscle elasticity

  • Netanel S. Berko
  • Erin F. FitzGerald
  • Terry D. Amaral
  • Monica Payares
  • Terry L. Levin
Original Article

Abstract

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.

Keywords

Ultrasound Elastography Children Muscle 

References

  1. 1.
    Klauser AS, Peetrons P (2010) Developments in musculoskeletal ultrasound and clinical applications. Skeletal Radiol 39:1061–1071CrossRefGoogle Scholar
  2. 2.
    Garra BS (2007) Imaging and estimation of tissue elasticity by ultrasound. Ultrasound Q 23:255–268PubMedCrossRefGoogle Scholar
  3. 3.
    Garra BS, Cespedes EI, Ophir J et al (1997) Elastography of breast lesions: Initial clinical results. Radiology 202:79–86PubMedGoogle Scholar
  4. 4.
    Itoh A, Ueno E, Tohno E et al (2006) Breast disease: Clinical application of US elastography for diagnosis. Radiology 239:341–350PubMedCrossRefGoogle Scholar
  5. 5.
    Lyshchik A, Higashi T, Asato R et al (2005) Thyroid gland tumor diagnosis at US elastography. Radiology 237:202–211PubMedCrossRefGoogle Scholar
  6. 6.
    Moon HJ, Sung JM, Kim EK et al (2012) Diagnostic performance of gray-scale US and elastography in solid thyroid nodules. Radiology 262:1002–1013PubMedCrossRefGoogle Scholar
  7. 7.
    Lalitha P, Reddy MC, Reddy KJ (2011) Musculoskeletal applications of elastography: A pictorial essay of our initial experience. Korean J Radiol 12:365–375PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Drakonaki EE, Allen GM, Wilson DJ (2012) Ultrasound elastography for musculoskeletal applications. Br J Radiol 85:1435–1445PubMedCrossRefGoogle Scholar
  9. 9.
    De Zordo T, Fink C, Feuchtner GM et al (2009) Real-time sonoelastography findings in healthy Achilles tendons. AJR Am J Roentgenol 193:W134–138PubMedCrossRefGoogle Scholar
  10. 10.
    De Zordo T, Chhem R, Smekal V et al (2010) Real-time sonoelastography: Findings in patients with symptomatic achilles tendons and comparison to healthy volunteers. Ultraschall Med 31:394–400PubMedCrossRefGoogle Scholar
  11. 11.
    De Zordo T, Lill SR, Fink C et al (2009) Real-time sonoelastography of lateral epicondylitis: Comparison of findings between patients and healthy volunteers. AJR Am J Roentgenol 193:180–185PubMedCrossRefGoogle Scholar
  12. 12.
    Kwon DR, Park GY, Lee SU et al (2012) Spastic cerebral palsy in children: Dynamic sonoelastographic findings of medial gastrocnemius. Radiology 263:794–801PubMedCrossRefGoogle Scholar
  13. 13.
    Kwon DR, Park GY (2012) Diagnostic value of real-time sonoelastography in congenital muscular torticollis. J Ultrasound Med 31:721–727PubMedGoogle Scholar
  14. 14.
    Clifford PS, Tschakovsky ME (2008) Rapid vascular responses to muscle contraction. Exerc Sport Sci Rev 36:25–29PubMedCrossRefGoogle Scholar
  15. 15.
    Yanagisawa O, Niitsu M, Kurihara T et al (2011) Evaluation of human muscle hardness after dynamic exercise with ultrasound real-time tissue elastography: A feasibility study. Clin Radiol 66:815–819PubMedCrossRefGoogle Scholar
  16. 16.
    Tschakovsky ME, Saunders NR, Webb KA et al (2006) Muscle blood-flow dynamics at exercise onset: Do the limbs differ? Med Sci Sports Exerc 38:1811–1818PubMedCrossRefGoogle Scholar
  17. 17.
    Miller AE, MacDougall JD, Tarnopolsky MA et al (1993) Gender differences in strength and muscle fiber characteristics. Eur J Appl Physiol Occup Physiol 66:254–262PubMedCrossRefGoogle Scholar
  18. 18.
    Kanehisa H, Ikegawa S, Fukunaga T (1994) Comparison of muscle cross-sectional area and strength between untrained women and men. Eur J Appl Physiol Occup Physiol 68:148–154PubMedCrossRefGoogle Scholar
  19. 19.
    Frank LR, Wong EC, Haseler LJ et al (1999) Dynamic imaging of perfusion in human skeletal muscle during exercise with arterial spin labeling. Magn Reson Med 42:258–267PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Netanel S. Berko
    • 1
  • Erin F. FitzGerald
    • 1
  • Terry D. Amaral
    • 2
  • Monica Payares
    • 2
  • Terry L. Levin
    • 1
  1. 1.Department of RadiologyMontefiore Medical CenterBronxUSA
  2. 2.Department of Orthopedic SurgeryMontefiore Medical CenterBronxUSA

Personalised recommendations