Shear wave elastography in the diagnosis of rhabdomyolysis

Abstract

Rhabdomyolysis is a life-threatening skeletal muscle disease, the time of diagnosis and initiation of treatment which directly affects the likelihood of developing acute kidney injury and the quality of recovery of muscle function. The ultrasound method of diagnostics is accessible and can be used at the stage of primary diagnosis, but it has low a sensitivity of 68% and specificity of 57% when using such ultrasound symptoms as a diffuse expressed increase of echogenicity (homogeneous or heterogeneous), a disorder of transverse striation of the muscle structure and high volume of the muscular tissue damage (over 30%).

The possibility of ultrasonic elastography in the diagnosis of rhabdomyolysis in 95 patients admitted with suspected damage to muscle tissue is discussed. Comparison of the parameters of shear wave elastography in patients with rhabdomyolysis and patients with other diseases manifested by muscle edema (muscle contusion, inflammatory myopathies, post-exercise muscle edema), as well as with the control group, significant differences were noted (p < 0.01) allows to determine the quantitative ultrasound characteristics of muscle tissue, pathognomonic for rhabdomyolysis. The use of shear wave elastography with obtaining lateral wave velocity of less than 1.64 m/s increased the sensitivity and specificity of the method in the diagnosis of rhabdomyolysis to 75 and 62%, respectively.

A logit model with integrated use of elastography indices was developed, with a diagnostic accuracy of 77%. During muscle recovery, there was an increase in lateral wave velocity to the level of control group values, which can be used as one of the markers of patient recovery.

Keywords

inflammatory myopathies / muscle edema / myalgia / rhabdomyolysis / shear wave elastography / skeletal muscles / ultrasound diagnostics of muscle

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RIGHTS & PERMISSIONS

Emelyantsev A.A., Bardakov S.N., Boikov I.V., Malakhovskiy V.N., Rameshvili T.E., Tsargush V.A., Romanov G.G., Bagrova A.A.