Application value of shear wave elastography in evaluating the quadriceps femoris lesions in patients with chronic obstructive pulmonary disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

NIU Yifan ^1,2 , YUE Yuanyuan ² , WANG Ruiqi ¹ ,  MA Xiaojuan ^1,2

1. School of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan 637100, P. R. China;
2. Department of Ultrasound, Chengdu First People’s Hospital, Chengdu, Sichuan 610000, P. R. China;

Corresponding author：

MA Xiaojuan, Email: xiaojuanma@126.com

Keywords：

Chronic obstructive pulmonary disease; quadriceps femoris muscle; shear wave elastography; Young’s modulus; two-dimensional ultrasound

DOI：

10.7507/1671-6205.202205025

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Objective To explore the clinical value of shear wave elastography in the evaluation of quadriceps femoris lesions in patients with chronic obstructive pulmonary disease (COPD). Methods Fifty-eight COPD patients who were admitted to Chengdu First People’s Hospital and 55 healthy controls were included in the study between August 2021 and February 2022. The thickness, circumference, cross-sectional area and Young's modulus of quadriceps femoris in all subjects were measured using shear wave elastography combined with conventional two-dimensional ultrasound. The differences in ultrasound parameters between the two groups were compared, and the correlation between each ultrasound parameter and clinical evaluation indicators (modified British Medical Research Council Scale, COPD Assessment Test, six-minute walk test, and five-time sit-to-stand test) was analyzed. Results Young’s modulus values of the quadriceps femoris muscle were smaller in the COPD group than those in the healthy control group [COPD Group: rectus femoris 6.72 (6.22, 7.36) kPa, vastus medialis 6.25 (5.82, 6.79) kPa, vastus lateralis 6.94 (6.17, 7.48) kPa; healthy control group: rectus femoris 11.40 (10.23, 12.11) kPa, vastus medialis 10.77 (9.62, 11.42) kPa, vastus lateralis 11.14 (10.42, 12.52) kPa]. The differences were statistically significant (all P<0.05). The Young's modulus value of the rectus femoris muscle correlates with the aforementioned clinical evaluation indicators, with positive correlation with six-minute walk distance and negative correlation with COPD Assessment Test, modified British Medical Research Council Scale, five-time sit-to-stand time (P<0.05). Quadriceps thickness, circumference, and cross-sectional area measured by conventional two-dimensional ultrasound were not significantly different between the two groups, nor were there significant correlations between each parameter and clinical parameters (P>0.05). In addition, shear wave elastography has good reproducibility in the measurement of Young's modulus in quadriceps. Conclusions Shear wave elastography can identify quadriceps lesions earlier than conventional two-dimensional ultrasound in COPD patients, and there is a significant correlation between its measurements and the clinical condition of COPD patients. Shear wave elastography may provide a simple and noninvasive method for clinical evaluation of quadriceps femoris lesions in COPD patients.

Citation： NIU Yifan, YUE Yuanyuan, WANG Ruiqi, MA Xiaojuan. Application value of shear wave elastography in evaluating the quadriceps femoris lesions in patients with chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(6): 396-402. doi: 10.7507/1671-6205.202205025 Copy

1.	Riley CM, Sciurba FC. Diagnosis and outpatient management of chronic obstructive pulmonary disease: a review. JAMA, 2019, 321(8): 786-797.
2.	Wang C, Xu JY, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
3.	Man WD, Soliman MG, Nikoletou D, et al. Non-volitional assessment of skeletal muscle strength in patients with chronic obstructive pulmonary disease. Thorax, 2003, 58(8): 665-669.
4.	Seymour JM, Spruit MA, Hopkinson NS, et al. The prevalence of quadriceps weakness in COPD and the relationship with disease severity. Eur Respir J, 2010, 36(1): 81-88.
5.	Kharbanda S, Ramakrishna A, Krishnan S. Prevalence of quadriceps muscle weakness in patients with COPD and its association with disease severity. Int J Chron Obstruct Pulmon Dis, 2015, 10(1): 1727-1735.
6.	Decramer M, Gosselink R, Troosters T, et al. Muscle weakness is related to utilization of health care resources in COPD patients. Eur Respir J, 1997, 10(2): 417-423.
7.	Jaitovich A, Barreiro E. Skeletal muscle dysfunction in chronic obstructive pulmonary disease: what we know and can do for our patients. Am J Respir Crit Care Med, 2018, 15(2): 175-186.
8.	Creze M, Nordez A, Soubeyrand M, et al. Shear wave sonoelastography of skeletal muscle: basic principles, biomechanical concepts, clinical applications, and future perspectives. Skeletal Radiol, 2018, 47(4): 457-471.
9.	Sigrist RMS, Liau J, Kaffas AE, et al. Ultrasound elastography: review of techniques and clinical applications. Theranostics, 2017, 7(5): 1303-1329.
10.	张丽, 王虹, 万毅新. 支气管内超声实时弹性成像技术的应用及研究进展. 中国呼吸与危重监护杂志, 2017, 7(5): 1303-1329.
11.	Taljanovic MS, Gimber LH, Becker GW, et al. Shear-wave elastography: basic physics and musculoskeletal applications. Radiographics, 2017, 37(3): 855-870.
12.	Xu JH, Wu ZZ, Tao FY, et al. Ultrasound shear wave elastography for evaluation of diaphragm stiffness in patients with stable COPD: a pilot trial. J Ultrasound Med, 2021, 40(12): 2655-2663.
13.	Labaki WW, Rosenberg SR. Chronic obstructive pulmonary disease. Ann Intern Med, 2020, 173(3): ITC17-ITC32.
14.	Chino K, Kawakami Y, Takahashi H. Tissue elasticity of in vivo skeletal muscles measured in the transverse and longitudinal planes using shear wave elastography. Clin Physiol Funct Imaging, 2017, 37(4): 394-399.
15.	Cortez CD, Hermitte L, Ramain A, et al. Ultrasound shear wave velocity in skeletal muscle: a reproducibility study. Diagn Interv Imaging, 2016, 97(1): 71-79.
16.	Zhou QT, Mei JJ, He B, et al. Chronic obstructive pulmonary disease assessment test score correlated with dyspnea score in a large sample of Chinese patients. Chin Med J (Engl), 2013, 126(1): 11-15.
17.	Cui LW, Ji XL, Xie MS, et al. Role of inspiratory capacity on dyspnea evaluation in COPD with or without emphysematous lesions: a pilot study. Int J Chron Obstruct Pulmon Dis, 2017, 12: 2823-2830.
18.	ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS Statement: Guidelines for the Six-Minute Walk Test. Am J Respir Crit Care Med, 2002, 166(1): 111-117. Erratum in: Am J Respir Crit Care Med, 2016, 193(10): 1185.
19.	Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull, 1979, 86(2): 420-428.
20.	Lacourpaille L, Hug F, Bouillard K, et al. Supersonic shear imaging provides a reliable measurement of resting muscle shear elastic modulus. Physiol Meas, 2012, 33(3): 19-28.
21.	Taş S, Onur MR, Yilmaz S, et al. Shear wave elastography is a reliable and repeatable method for measuring the elastic modulus of the rectus femoris muscle and patellar tendon. J Ultrasound Med, 2017, 36(3): 565-570.
22.	Donaldson AV, Maddocks M, Martolini D, et al. Muscle function in COPD: a complex interplay. Int J Chron Obstruct Pulmon Dis, 2012, 7: 523-535.
23.	Maynard-Paquette AC, Poirier C, Chartrand-Lefebvre C, et al. Ultrasound evaluation of the quadriceps muscle contractile index in patients with stable chronic obstructive pulmonary disease: relationships with clinical symptoms, disease severity and diaphragm contractility. Int J Chron Obstruct Pulmon Dis, 2020, 15: 79-88.
24.	Ruas CV, Brown LE, Lima CD, et al. Different muscle action training protocols on quadriceps-hamstrings neuromuscular adaptations. Int J Sports Med, 2018, 39(5): 355-365.

1. Riley CM, Sciurba FC. Diagnosis and outpatient management of chronic obstructive pulmonary disease: a review. JAMA, 2019, 321(8): 786-797.
2. Wang C, Xu JY, Yang L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health study): a national cross-sectional study. Lancet, 2018, 391(10131): 1706-1717.
3. Man WD, Soliman MG, Nikoletou D, et al. Non-volitional assessment of skeletal muscle strength in patients with chronic obstructive pulmonary disease. Thorax, 2003, 58(8): 665-669.
4. Seymour JM, Spruit MA, Hopkinson NS, et al. The prevalence of quadriceps weakness in COPD and the relationship with disease severity. Eur Respir J, 2010, 36(1): 81-88.
5. Kharbanda S, Ramakrishna A, Krishnan S. Prevalence of quadriceps muscle weakness in patients with COPD and its association with disease severity. Int J Chron Obstruct Pulmon Dis, 2015, 10(1): 1727-1735.
6. Decramer M, Gosselink R, Troosters T, et al. Muscle weakness is related to utilization of health care resources in COPD patients. Eur Respir J, 1997, 10(2): 417-423.
7. Jaitovich A, Barreiro E. Skeletal muscle dysfunction in chronic obstructive pulmonary disease: what we know and can do for our patients. Am J Respir Crit Care Med, 2018, 15(2): 175-186.
8. Creze M, Nordez A, Soubeyrand M, et al. Shear wave sonoelastography of skeletal muscle: basic principles, biomechanical concepts, clinical applications, and future perspectives. Skeletal Radiol, 2018, 47(4): 457-471.
9. Sigrist RMS, Liau J, Kaffas AE, et al. Ultrasound elastography: review of techniques and clinical applications. Theranostics, 2017, 7(5): 1303-1329.
10. 张丽, 王虹, 万毅新. 支气管内超声实时弹性成像技术的应用及研究进展. 中国呼吸与危重监护杂志, 2017, 7(5): 1303-1329.
11. Taljanovic MS, Gimber LH, Becker GW, et al. Shear-wave elastography: basic physics and musculoskeletal applications. Radiographics, 2017, 37(3): 855-870.
12. Xu JH, Wu ZZ, Tao FY, et al. Ultrasound shear wave elastography for evaluation of diaphragm stiffness in patients with stable COPD: a pilot trial. J Ultrasound Med, 2021, 40(12): 2655-2663.
13. Labaki WW, Rosenberg SR. Chronic obstructive pulmonary disease. Ann Intern Med, 2020, 173(3): ITC17-ITC32.
14. Chino K, Kawakami Y, Takahashi H. Tissue elasticity of in vivo skeletal muscles measured in the transverse and longitudinal planes using shear wave elastography. Clin Physiol Funct Imaging, 2017, 37(4): 394-399.
15. Cortez CD, Hermitte L, Ramain A, et al. Ultrasound shear wave velocity in skeletal muscle: a reproducibility study. Diagn Interv Imaging, 2016, 97(1): 71-79.
16. Zhou QT, Mei JJ, He B, et al. Chronic obstructive pulmonary disease assessment test score correlated with dyspnea score in a large sample of Chinese patients. Chin Med J (Engl), 2013, 126(1): 11-15.
17. Cui LW, Ji XL, Xie MS, et al. Role of inspiratory capacity on dyspnea evaluation in COPD with or without emphysematous lesions: a pilot study. Int J Chron Obstruct Pulmon Dis, 2017, 12: 2823-2830.
18. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS Statement: Guidelines for the Six-Minute Walk Test. Am J Respir Crit Care Med, 2002, 166(1): 111-117. Erratum in: Am J Respir Crit Care Med, 2016, 193(10): 1185.
19. Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull, 1979, 86(2): 420-428.
20. Lacourpaille L, Hug F, Bouillard K, et al. Supersonic shear imaging provides a reliable measurement of resting muscle shear elastic modulus. Physiol Meas, 2012, 33(3): 19-28.
21. Taş S, Onur MR, Yilmaz S, et al. Shear wave elastography is a reliable and repeatable method for measuring the elastic modulus of the rectus femoris muscle and patellar tendon. J Ultrasound Med, 2017, 36(3): 565-570.
22. Donaldson AV, Maddocks M, Martolini D, et al. Muscle function in COPD: a complex interplay. Int J Chron Obstruct Pulmon Dis, 2012, 7: 523-535.
23. Maynard-Paquette AC, Poirier C, Chartrand-Lefebvre C, et al. Ultrasound evaluation of the quadriceps muscle contractile index in patients with stable chronic obstructive pulmonary disease: relationships with clinical symptoms, disease severity and diaphragm contractility. Int J Chron Obstruct Pulmon Dis, 2020, 15: 79-88.
24. Ruas CV, Brown LE, Lima CD, et al. Different muscle action training protocols on quadriceps-hamstrings neuromuscular adaptations. Int J Sports Med, 2018, 39(5): 355-365.

Chinese Journal of Respiratory and Critical Care Medicine

Application value of shear wave elastography in evaluating the quadriceps femoris lesions in patients with chronic obstructive pulmonary disease

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