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. 2019 Sep 12;29(3):8476.
doi: 10.4081/ejtm.2019.8476. eCollection 2019 Aug 2.

Stiffness and echogenicity: Development of a stiffness-echogenicity matrix for clinical problem solving

Antonio Stecco  1 , Carmelo Pirri  2 , Raffaele De Caro  3 , Preeti Raghavan  4
Affiliations

Stiffness and echogenicity: Development of a stiffness-echogenicity matrix for clinical problem solving

Antonio Stecco et al. Eur J Transl Myol. .

Abstract

The assessment of soft tissue stiffness is important to evaluate many neuromusculoskeletal conditions. Several tools have been proposed for the assessment of stiffness, but ultrasonography appears to be most practical. The reflection of ultrasound waves as it travels through tissue enables assessment of tissue echogenicity, which is influenced by the characteristics of the sound wave as well as the characteristics of the tissue through which it passes, such as the amount of fat and fibrous tissue. However, tissue stiffness is not directly proportional to its echogenicity. Hence evaluation of echogenicity, as a stand-alone technique, is inadequate to describe its mechanical properties. The aim of this manuscript is to present a method of combining echogenicity evaluation by ultrasound and stiffness evaluation by palpation to better describe the mechanical properties of muscle using a stiffness-echogenicity matrix.

Keywords: echogenicity; elastography; stiffness; ultrasound.

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Conflict of interest statement

We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Figures

Fig 1.
Fig 1.
The stiffness rating scale assesses the compressibility of the underlying muscle by palpation to estimate the resistance of the tissue to displacement
Fig 2.
Fig 2.
Presents a stiffness-echogenicity matrix (SEM) which combines stiffness rating on the y-axis with echogenicity rating on the x-axis. Each quadrant of the matrix can represent a wide spectrum of conditions seen in clinical practice.
Fig 3.
Fig 3.
The cells in the SEM represent clinical conditions that show various degrees of muscle stiffness and echogenicity. The color of each cell in the matrix reflects the echogenicity grey-scale.
See this image and copyright information in PMC

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References

    1. Pillen S, van Alfen N. Skeletal muscle ultrasound. Neurol Res 2011;33:1016-24. - PubMed
    1. Correa-de-Araujo R, Harris-Love MO, Miljkovic I, et al. The need for standardized assessment of muscle quality in skeletal muscle function deficit and other aging-related muscle dysfunctions: A symposium report. Front Physiol 2017;8:1–19. - PMC - PubMed
    1. Iftekharuddin KM, Awwal AAS. Field Guide to Image Processing; SPIE Field Guides; SPIE Press: Bellingham, WA, USA, 2012. ISBN 978-0-8194-9021-6.
    1. Pillen S, Tak RO, Zwarts MJ, et al. Skeletal muscle ultrasound: correlation between fibrous tissue and echo intensity. Ultrasound Med Biol 2009;35:443-6. - PubMed
    1. Reimers K, Reimers CD, Wagner S, et al. Skeletal muscle sonography: a correlative study of echogenicity and morphology. J Ultrasound Med 1993. 12:73-7. - PubMed