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In Vivo Study of Transverse Carpal Ligament Stiffness Using Acoustic Radiation Force Impulse (ARFI) Imaging

机译：使用声辐射力脉冲（ARFI）成像的腕骨横韧度的体内研究

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摘要

The transverse carpal ligament (TCL) forms the volar boundary of the carpal tunnel and may provide mechanical constraint to the median nerve, leading to carpal tunnel syndrome. Therefore, the mechanical properties of the TCL are essential to better understand the etiology of carpal tunnel syndrome. The purpose of this study was to investigate the in vivo TCL stiffness using acoustic radiation force impulse (ARFI) imaging. The shear wave velocity (SWV) of the TCL was measured using Virtual Touch IQTM software in 15 healthy, male subjects. The skin and the thenar muscles were also examined as reference tissues. In addition, the effects of measurement location and ultrasound transducer compression on the SWV were studied. The SWV of the TCL was dependent on the tissue location, with greater SWV values within the muscle-attached region than those outside of the muscle-attached region. The SWV of the TCL was significantly smaller without compression (5.21 ± 1.08 m/s) than with compression (6.62 ± 1.18 m/s). The SWV measurements of the skin and the thenar muscles were also affected by transducer compression, but to different extents than the SWV of the TCL. Therefore to standardize the ARFI imaging procedure, it is recommended that a layer of ultrasound gel be maintained to minimize the effects of tissue compression. This study demonstrated the feasibility of ARFI imaging for assessing the stiffness characteristics of the TCL in vivo, which has the potential to identify pathomechanical changes of the tissue.
机译：腕横韧带（TCL）形成腕管的掌侧边界，并可能对正中神经提供机械约束，从而导致腕管综合症。因此，TCL的力学性能对于更好地了解腕管综合症的病因至关重要。这项研究的目的是研究使用声辐射力脉冲（ARFI）成像的体内TCL硬度。使用Virtual Touch IQ TM 软件在15位健康的男性受试者中测量了TCL的剪切波速度（SWV）。还检查了皮肤和muscle肌作为参考组织。此外，还研究了测量位置和超声换能器压缩对SWV的影响。 TCL的SWV取决于组织的位置，在肌肉附着区域内的SWV值大于在肌肉附着区域外的SWV值。没有压缩时（5.21±1.08 m / s），TCL的SWV显着小于压缩时（6.62±1.18 m / s）。皮肤和compression肌的SWV测量值也受换能器压缩的影响，但程度与TCL的SWV不同。因此，为了使ARFI成像程序标准化，建议保留一层超声凝胶，以最大程度地减少组织受压的影响。这项研究证明了ARFI成像在评估TCL体内硬度特征方面的可行性，这具有识别组织的病理力学变化的潜力。

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