Ultrasound elastography of back muscle biomechanical properties: a systematic review and meta-analysis of current methods.

Autor: David M; Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montreal, QC, H2L 2W5, Canada.; Institute of Biomedical Engineering, University of Montreal, Montreal, QC, H3C 3J7, Canada., Devantéry K; University of Sherbrooke, Sherbrooke, QC, J1K 2R1, Canada., Nauche B; University of Montreal Hospital, Montreal, QC, H3X 0C1, Canada., Chagnon M; Department of Mathematics and Statistics, University of Montreal, Montreal, QC, H2C 3J7, Canada., Keezer M; University of Montreal Hospital, Montreal, QC, H3X 0C1, Canada.; Department of Neurology, University of Montreal, Montreal, QC, H2C 3J7, Canada., Gaudreault N; University of Sherbrooke, Sherbrooke, QC, J1K 2R1, Canada., Bureau NJ; University of Montreal Hospital, Montreal, QC, H3X 0C1, Canada.; Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, QC, H3C 3J7, Canada., Cloutier G; Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center, Montreal, QC, H2L 2W5, Canada. guy.cloutier@umontreal.ca.; Institute of Biomedical Engineering, University of Montreal, Montreal, QC, H3C 3J7, Canada. guy.cloutier@umontreal.ca.; Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, QC, H3C 3J7, Canada. guy.cloutier@umontreal.ca.
Jazyk: angličtina
Zdroj: Insights into imaging [Insights Imaging] 2024 Aug 14; Vol. 15 (1), pp. 206. Date of Electronic Publication: 2024 Aug 14.
DOI: 10.1186/s13244-024-01785-7
Abstrakt: Objectives: To report the current elastography methods used to quantify back muscles' biomechanical characteristics in patients with musculoskeletal disorders (MSKd) and inform on their reliability, validity, and responsiveness.
Methods: MEDLINE, Embase, CINAHL, Cochrane library and grey literature were consulted. Predefined criteria allowed for study selection and data extraction. The quality of evidence was rated using the COSMIN tool. Data were meta-analyzed in terms of pooled intraclass correlation coefficient (pICC) for reliability and pooled standardized mean difference (pSMD) for validity and responsiveness. Heterogeneity was assessed.
Results: Seventy-nine studies were included in the meta-analysis (total number of participants N = 3178). Three elastography methods were identified: strain imaging (SI; number of cohorts M = 26), shear wave imaging (SWI; M = 50), and vibration sonoelastography (VSE; M = 3). Strain imaging and SWI studies reported good reliability measurement properties (pICC > 0.70) and a medium pSMD (0.58 for SI and 0.60 for SWI; p ≤ 0.020) in discriminating MSKd from controls' condition (validity). Strain imaging studies reported a medium pSMD (0.64; p = 0.005) in detecting within-group changes over time, whereas SWI pSMD was very high (1.24; p = 0.005). Only SWI reported significant but small pSMD (0.30; p = 0.003) in detecting between-group changes over time. The small number of VSE studies could not be meta-analyzed. Heterogeneity was high (I-squared > 90%; p < 0.001).
Conclusions: Elastography presents good reliability results and a medium pSMD in discriminating MSKd from control conditions. Responsiveness data suggest detectable changes within groups over time using SI and SWI, calling for long-term longitudinal studies. Assessing changes between groups over time using elastography still needs to be proven. Highly significant heterogeneity limits meta-analytic results.
Critical Relevance Statement: While still in its early-stage exploration phase, musculoskeletal ultrasound elastography may reliably quantify back muscles' biomechanics in asymptomatic individuals, moderately discriminate back musculoskeletal disorders and detect biomechanical changes over time in these conditions, calling for long-term longitudinal studies.
Key Points: Ultrasound elastography is reviewed for back pain and related musculoskeletal disorder assessments. Growing literature supports good reproducibility, some validity and responsiveness. Back muscle elastography considers assumptions calling for standardized protocols.
(© 2024. The Author(s).)
Databáze: MEDLINE
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