Ultrasound Imaging of Injections in Masseter Muscle without Contrast Agent Using Strain Elastography and a Novel B-Mode Spatiotemporal Filter
| Autor: | Jasmine Kuonen, Sergio J. Sanabria, Vera Colombo, Susanne Dettwiler, Dominik A Ettlin, Marga B. Rominger, Thomas Frauenfelder, Lisa Ruby |
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| Přispěvatelé: | University of Zurich, Sanabria, Sergio J |
| Rok vydání: | 2020 |
| Předmět: |
Adult
myalgia Acoustics and Ultrasonics Swine Biophysics Contrast Media 610 Medicine & health Strain (injury) Myofascial pain syndrome Injections Masseter muscle 03 medical and health sciences Spatio-Temporal Analysis 0302 clinical medicine 10049 Institute of Pathology and Molecular Pathology 3102 Acoustics and Ultrasonics medicine Animals Humans Radiology Nuclear Medicine and imaging Botulinum Toxins Type A 3614 Radiological and Ultrasound Technology 030304 developmental biology 0303 health sciences Radiological and Ultrasound Technology Injection Procedure Masseter Muscle 10042 Clinic for Diagnostic and Interventional Radiology business.industry Ultrasound 10223 Clinic for Masticatory Disorders Echogenicity Myalgia medicine.disease Masticatory force Neuromuscular Agents Elasticity Imaging Techniques Feasibility Studies Female medicine.symptom business Algorithms 030217 neurology & neurosurgery 1304 Biophysics Biomedical engineering |
| Zdroj: | Ultrasound in Medicine & Biology. 46:2717-2735 |
| ISSN: | 0301-5629 |
| Popis: | Botulinum toxin type A (BTX-A) injections in masseter muscle can alleviate muscle tightness and aching pain caused by idiopathic masticatory myalgia, a subform of the myofascial pain syndrome. Yet the injection procedure (number, amount) is currently empirical. In this ex vivo study, we determined the feasibility of using contrast-free ultrasound imaging to visualize the short-term injectate propagation. Ultrasound annotations of BTX-A injectate spread in N = 12 porcine masseter muscles were compared with the histopathology of the excised masseter. BTX-A presence was automatically detected in the ultrasound cine by: compensating tissue motion and deformation during injection with a novel spatiotemporal filtering (SF) algorithm, and by imaging tissue swelling strains with strain elastography (SE). BTX-A injectate introduced 6.5% (standard deviation = 5.0%) echogenicity contrast and 13.9% (standard deviation = 3.7%) tissue swelling strain. Muscle fasciae were a border for BTX-A distribution. The SF algorithm achieved significantly higher noise rejection (contrast-to-noise ratio = 4.63) than SE (2.56, p = 0.01), and state-of-the-art 2-D digital image correlation (1.81, p0.001) and direct image subtraction (1.29, p0.001) methods. Histopathology agreed well with ultrasound (Dice coefficient = 0.48), with deviations mainly explained by the three-dimensional inhomogeneous distribution of BTX-A. Preliminary in vivo patient results indicated that SF and SE discard artifactual BTX-A detection outside the injection region. The proposed methods contribute to objectivize ultrasound-guided injections, with additional applications, for instance, to monitor injectate spread of local anesthetics. |
| Databáze: | OpenAIRE |
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