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Quantitative assessment of muscular stiffness in children with cerebral palsy using acoustic radiation force impulse (ARFI) ultrasound elastography

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Abstract

Purpose

To evaluate the feasibility of quantitative analysis of muscle stiffness in the medial gastrocnemius muscle (GCM) by acoustic radiation force impulse (ARFI) ultrasound elastography in children with spastic cerebral palsy (CP).

Methods

Seventeen children with spastic CP and 25 healthy children participated in the study between the years 2016–2017. The medial GCM in the CP group was assessed using the Modified Ashworth Scale (MAS) by a physiatrist. ARFI was used to measure the shear-wave velocities (SWVs) of the medial GCM. The mean SWV value for each MAS score was calculated and used for statistics.

Results

The mean SWV values of the medial GCM in the CP and healthy groups were 3.17 ± 0.81 m/s (mean ± SD) and 1.45 ± 0.25 m/s (mean ± SD), respectively. The SWV of the medial GCM significantly increased in the CP patients when compared with controls (p < 0.001). In addition, the SWV values were correlated with the MAS scores (p < 0.001). The interobserver agreement expressed as the interclass correlation coefficient was 0.65 (95% CI 0.33–0.84, p < 0.001).

Conclusions

ARFI imaging demonstrated a difference in muscle stiffness in the medial GCM between the CP and healthy groups. This method is a feasible imaging modality for the noninvasive assessment of contracting muscles in children with CP.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey

    Meltem Ceyhan Bilgici & Mustafa Bekir Selcuk

  2. Radiology Clinic, Zonguldak State Hospital, Zonguldak, Turkey

    Tumay Bekci

  3. Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey

    Yasemin Ulus

  4. Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey

    Hamit Ozyurek & Omer Faruk Aydin

  5. Department of Medical Biostatistics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey

    Leman Tomak

Authors
  1. Meltem Ceyhan Bilgici
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  2. Tumay Bekci
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  3. Yasemin Ulus
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  4. Hamit Ozyurek
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  5. Omer Faruk Aydin
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  6. Leman Tomak
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  7. Mustafa Bekir Selcuk
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Corresponding author

Correspondence to Tumay Bekci.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical statements

The study was approved by the Medical Ethics Committee of the University Hospital, and all subjects provided written informed consent.

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Cite this article

Bilgici, M.C., Bekci, T., Ulus, Y. et al. Quantitative assessment of muscular stiffness in children with cerebral palsy using acoustic radiation force impulse (ARFI) ultrasound elastography. J Med Ultrasonics 45, 295–300 (2018). https://doi.org/10.1007/s10396-017-0824-3

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  • DOI: https://doi.org/10.1007/s10396-017-0824-3

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