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Ability of magnetic resonance elastography to assess taut bands

PainSci » bibliography » Chen et al 2008
Tags: muscle pain, imaging, etiology, diagnosis, muscle, pain problems, pro

Three articles on PainSci cite Chen 2008: 1. The Complete Guide to Trigger Points & Myofascial Pain2. Toxic Muscle Knots3. The Trigger Point Identity Crisis

PainSci commentary on Chen 2008: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

Magnetic resonance elastrography (MRE) can probably show areas of differential stiffness in muscle tissue, as shown in a pilot study by these researchers the previous year.

To further establish the validity of the technique, Chen et al used it on gelatin models of muscle tissue: a chunk of gelatin all of the same consistency, and another chunk containing a core of stiffer gelatin, representing a “taut band.” This confirmed what MRE results look like when examining simple models of tissue stiffness.

MRE was then used to compare muscle tissue in eight people, four healthy, and four with chronic pain presumed to be caused by trigger points. MRE clearly showed regions of stiffness in the patients with pain, but not in the pain-free patients. “This study suggests that magnetic resonance elastography may have a potential for objectively characterizing myofascial taut bands that have been up to now detectable only by the clinician’s fingers.”

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

BACKGROUND: Myofascial taut bands are central to diagnosis of myofascial pain. Despite their importance, we still lack either a laboratory test or imaging technique capable of objectively confirming either their nature or location. This study explores the ability of magnetic resonance elastography to localize and investigate the mechanical properties of myofascial taut bands on the basis of their effects on shear wave propagation.

METHODS: This study was conducted in three phases. The first involved the imaging of taut bands in gel phantoms, the second a finite element modeling of the phantom experiment, and the third a preliminary evaluation involving eight human subjects-four of whom had, and four of whom did not have myofascial pain. Experiments were performed with a 1.5 T magnetic resonance imaging scanner. Shear wave propagation was imaged and shear stiffness was reconstructed using matched filtering stiffness inversion algorithms.

FINDINGS: The gel phantom imaging and finite element calculation experiments supported our hypothesis that taut bands can be imaged based on its outstanding shear stiffness. The preliminary human study showed a statistically significant 50-100% (P=0.01) increase of shear stiffness in the taut band regions of the involved subjects relative to that of the controls or in nearby uninvolved muscle.

INTERPRETATION: This study suggests that magnetic resonance elastography may have a potential for objectively characterizing myofascial taut bands that have been up to now detectable only by the clinician's fingers.

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