• The Journal of Internal Korean Medicine
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• v.35 no.1
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• pp.1-11
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• 2014

Objectives : To investigate the effects of Sa-am acupuncture on muscle architecture and elastic properties of the spastic elbow flexor and to evaluate the correlation between clinical findings and parameters of real-time sonoelastography (RTS) in patients with chronic post-stroke hemiparesis. Materials and Methods : Seven patients (five males, two females) with chronic post-stroke hemiparesis were included. Sa-am acupuncture of Ganseunggyeok (肝勝格: LU8 LR4 補, HT8 LR2 瀉) was applied to the unaffected side 3 times a week for 4 weeks. During each acupuncture treatment period, patients were requested to exercise their affected arm, and spasticity and functional recovery outcomes of the affected arm were evaluated before and after Sa-am acupuncture treatment. Clinical outcomes were assessed using motricity index (MI), modified Ashworth scale (MAS), Fugl-Meyer assessment scale (FMA) and modified Barthel index (MBI) for elbow flexor spasticity. RTS images indicate the relative hardness of the examined muscles ranged from red (hard) to purple (soft) for color-scale, and from black (hard) to white (soft) for hue scale. Color and hue histograms of the biceps brachii and brachialis were analyzed using Image J software, and median red, blue, and hue pixel intensity were obtained. Results : MI and FMA score significantly increased and MAS score significantly decreased (p<0.05). F-wave maximal amplitude of affected abductor pollicis brevis significantly decreased (p<0.05). Muscle thickness of affected brachialis significantly increased (p<0.05). Red and green pixel intensity of affected brachialis significantly decreased (p<0.05). Conclusions : Our study revealed that Sa-am acupuncture is effective as a useful and safe treatment for spasticity in chronic post-stroke hemiparesis.

• The Journal of the Acoustical Society of Korea
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• v.24 no.5
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• pp.282-293
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• 2005

Sonoelastography is an ultrasound-based technique that visualizes the elastic properties of soft tissues by measuring the tissue motion generated by an externally applied vibration. In this paper. the characteristics of wave generation in soft tissues due to an acoustic vibrator are studied. The effects of modal patterns on the detectability of lesions such as tumors in senoelastography are also investigated These are accomplished by analyzing the vibration patterns calculated using theoretical equations and finite element methods in halt space, infinite plate. and finite-sized tissue. A finite-width source generates shear waves with large amplitude Propagating in specific directions. and the generation characteristics depend both on the width and frequency of the vibrator. as well as the distance from it. It is shown in a finite-sized tissue that the lesion detection in displacement images is quit dependent on the modal patterns inside tissue. In contrast it Is also found that the lesion detectability in strain images is less dependent on the modal Patterns and is much better than that in displacement images.

• Clinics in Shoulder and Elbow
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• v.17 no.3
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• pp.107-113
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• 2014

Background: Sonoelastography (SE) is a new technique that can assess differences in tissue stiffness, the purpose of this study was to evaluate the ability of SE to assess the long head of biceps tendon alteration. Methods: Forty shoulders of 36 consecutively registered patients with clinical symptoms and conventional ultrasonography findings of biceps tendinitis or tendinosis, and 40 asymptomatic shoulders of 20 healthy volunteers were assessed with SE. Transverse and longitudinal images of long head of biceps tendon were obtained using SE. SE images were performed by one orthopedic surgeon and evaluated by two orthopedic surgeons using an experimentally proven color grading system. Results: The transverse images of SE showed a sensitivity of 87.5%, a specificity of 95.0% and a accuracy of 91.3%, the longitudinal images of SE showed a sensitivity of 92.5%, a specificity of 90.0% and a accuracy of 91.3%. Inter-observer reliability of SE was in 'almost perfect agreement' with a weighted kappa coefficient of 0.83. Conclusions: SE is valuable in the detection of the intratendinous and peritendinous alterations of biceps tendon, and has excellent accuracy and excellent correlation with conventional ultrasound findings.

• Journal of the Korean Society of Radiology
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• v.81 no.1
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• pp.176-189
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• 2020

Purpose To evaluate the clinical efficacy of real-time sonoelastography (RTS) for the follow-up of congenital muscular torticollis, based on measurements of muscle elasticity. Materials and Methods Thirty-four infants (23 male, 11 female) with congenital sternocleidomastoid (SCM) muscle torticollis underwent ultrasonography and elastography between November 2012 and December 2014. We evaluated the thickness, morphology (mass-like, fusiform, or overall thickened shape), and echogenicity of the SCM muscle on grayscale images and color patterns (homogeneous blue, mixed green < 50% and ≥ 50%, and green to red) on elastography. Strain ratios were measured using Q-lab software. A clinician classified the degree of neck rotation and side flexion deficits using a 5-point grade system based on angles of neck rotation and side flexion. Correlations between the ultrasonography and clinical findings were evaluated by statistical analysis. Results Twenty-two infants had right and 12 had left SCM torticollis, respectively. Linear regression analysis showed that involved/contralateral SCM thickness differences, morphology, elasticity color scores, and strain ratios of the affected SCM muscles were significantly correlated with neck rotation and side flexion deficit scores (p < 0.05). The elasticity color score of the affected SCM muscle was the most significant factor. Conclusion RTS might provide a reliable means for evaluating and monitoring congenital muscular torticollis.

• The Journal of the Acoustical Society of Korea
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• v.29 no.1E
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• pp.1-10
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• 2010

The difference in echogenicity between cancerous and normal tissues is not quite distinguishable in ultrasound B-mode imaging. However, tumor or cancer in breast or prostate tends to be stiffer than the surrounding normal tissue. Thus, imaging the stiffness contrast between the two different tissue types is helpful for quantitative diagnosis, and such a method of imaging the elasticity of human tissue is collectively referred to as ultrasound elasticity imaging. Recently, elasticity imaging has established itself as an effective diagnostic modality in addition to ultrasound B-mode imaging. The purpose of this paper is to present various elasticity imaging methods that have been reported up to now and to describe their principles of operation and characteristics.

• Journal of Yeungnam Medical Science
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• v.41 no.3
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• pp.179-187
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• 2024

Myofascial pain syndrome (MPS) is a common musculoskeletal disorder characterized by muscle pain, tenderness, and trigger points. Ultrasonography has emerged as a key tool for diagnosing and treating MPS owing to its ability to provide precise, minimally invasive guidance. This review discusses the use of ultrasonography in various approaches to evaluate and manage MPS. Studies have shown that shear-wave sonoelastography can effectively assess muscle elasticity and offer insights into trapezius stiffness in patients with MPS. Ultrasound-guided interfascial hydrodissection, especially with visual feedback, has demonstrated effectiveness in treating trapezius MPS. Similarly, ultrasound-guided rhomboid interfascial plane blocks and perimysium dissection for posterior shoulder MPS have significantly reduced pain and improved quality of life. The combination of extracorporeal shockwave therapy with ultrasound-guided lidocaine injections has been particularly successful in reducing pain and stiffness in trapezius MPS. Research regarding various guided injections, including dry needling, interfascial plane blocks, and fascial hydrodissection, emphasizes the importance of ultrasonography for accuracy and safety. Additionally, ultrasound-guided delivery of local anesthetics and steroids to the quadratus lumborum muscle has shown lasting pain relief over a 6-month period. Overall, these findings highlight the pivotal role of ultrasonography in the assessment and treatment of MPS.