Wednesday, January 20, 2021

In Vivo Visualization of Tissue Damage Induced by Percutaneous Muscle Biopsy via Novel High-Resolution MR Imaging

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Purpose Percutaneous muscle biopsy is the gold standard for tissue assessment in clinical practice and scientific studies. The aim of this study was to assess and quantify the ensuing tissue damage by in vivo magnetic resonance imaging (MRI). Methods In this prospective study we enrolled 22 healthy participants, who underwent MRI of the thigh musculature about one week after a percutaneous muscle biopsy of the vastus lateralis muscle. A total of 17 participants also volunteered for a second MR-examination two weeks after biopsy. Volumes of SWI lesions and muscle edema were assessed by susceptibility-weighted imaging (SWI) and T2-weighted MRI, respectively, after manual segmentation by two independent readers. For quantitative in vivo hematoma volume assessment, we additionally determined signal changes induced by experimental hematoma in an ex vivo model. Results Mean overall volume of SWI lesions one week after biopsy was 26.5 ± 21.7 μl, accompanied by a mean perifocal edema volume of 790.1 ± 591.4 μl. In participants who underwent two examinations mean volume of SWI lesions slightly decreased from 29.8 ± 23.6 μl to 23.9 ± 16.8 μl within one week (p=0.13). Muscle edema volume decreased from 820.2 ± 632.4 μl to 359.6 ± 207.3 μl at the same time (p=0.006). By calibration with the ex vivo findings, signal alterations on SWI corresponded to a blood volume of approximately 10 - 50 μl. Conclusion Intramuscular hematoma and accompanying muscle edema after percutaneous biopsy are small and decrease rapidly within the first two weeks. These in vivo findings underline the limited invasiveness of the procedure. Accepted for Publication: 11 December 2020 Correspondence: Tim Hilgenfeld, MD, Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Email: Tim.Hilgenfeld@med.uni-heidelberg.de Supported in part by the German Research Council (SFB 1118, S.H.; SFB 1158, M.B.). The authors have no commercial or financial conflicts of interest to declare. The results are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation and do not constitute endorsement by the American College of Sports Medicine. © 2021 American College of Sports Medicine
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