Muscle

Background

Neuromuscular disorders cover a large number of different muscle diseases. Symptoms of these diseases may include muscle pain, atrophy, numbness, weakness, twitching, and paresthesia. Given that the underlying cause of these symptoms varies heavily, adequate diagnosis and treatment is of importance in order to give this group of patients the care they need. Imaging with ultrasound proved to add value in detection, and diagnosing neuromuscular disorders. Besides basic properties as muscle thickness, also other quantitative parameters like echo intensity (EI) are explored and showed the possibility to be of added value. Besides the static aspects of ultrasound, also dynamic and functional imaging can be performed. For instance, fasciculations or changed contraction patterns are functional measures that can assess the underlying mechanisms that result in the patients’ symptoms. Our research is focused on further development of the possibilities that ultrasound can offer in the improvement of detecting, diagnosing, staging, and follow-up of neuromuscular disorders. And to not only provide new methods for research, but with the actual clinical application as final goal.


Method section

The ultrasound techniques involved in this field of applications are; quantitative imaging and strain imaging. Using quantitative imaging, objective measures can be retrieved by non-invasive scanning of muscles. Parameters as muscle thickness, EI, attenuation and others are under investigation in past and recent literature with promising results (Alfen et al 2018). After gaining expertise from previous quantitative studies and findings in literature we aim to extend the possibilities even further and facilitate the translation to implement these methods in clinics. The same holds for functional imaging, the high temporal resolution of ultrasound can be exploited to capture the way muscles deform (Gijsbertse et al. 2017). This method of strain imaging proves sensitive to reveal normal versus abnormal function of muscle, thereby providing physicians with functional information of the patient.


Results

Quantitative ultrasound is already implemented in our hospital for the clinical evaluation of patients with a (suspected) neuromuscular disorder. However, ongoing developments of this method are part of our current line of work. One of these developments is the extension to 3D imaging for skeletal ultrasound of which the example image below demonstrates the outcome.

Muscle3D.jpg
Figure 1: 3D ultrasound of the quadriceps muscle showing the vastus lateralis, vastus intermedius and femur

Funding

MURAB: MRI and Ultrasound Robotic Assisted Biopsy (supported by Horizon 2020 (688188), Siemens, and KUKA, active). https://www.murabproject.eu/


Publications

  • L. de Jong, M. Welleweerd, J. van Zelst, F. Siepel, S. Stramigioli, R. Mann, C. de Korte and J. Fütterer. "Production and clinical evaluation of breast lesion skin markers for automated three-dimensional ultrasonography of the breast: a pilot study.", 2020. Abstract/PDF DOI PMID

  • N. van Alfen, K. Gijsbertse and C. de Korte. "How useful is muscle ultrasound in the diagnostic workup of neuromuscular diseases?", 2018. Abstract/PDF DOI PMID

  • K. Gijsbertse, R. Goselink, S. Lassche, M. Nillesen, A. Sprengers, N. Verdonschot, N. van Alfen and C. de Korte. "Ultrasound Imaging of Muscle Contraction of the Tibialis Anterior in Patients with Facioscapulohumeral Dystrophy.", 2017. Abstract DOI PMID

  • S. Pillen, J. van Dijk, G. Weijers, W. Raijmann, C. de Korte and M. Zwarts. "Quantitative gray-scale analysis in skeletal muscle ultrasound: a comparison study of two ultrasound devices", 2009. Abstract/PDF DOI PMID



People

  • Kaj Gijsbertse

Clinical collaborators

  • Jurgen Futterer
  • Nens van Alfen
  • Jonne Doorduin
  • Juerd Wijntjes
  • Baziel van Engelen