Shear modulus of multifidus and longissimus muscles measured using shear wave elastography correlates with muscle activity, but depends on image quality

Abstract

Shear wave elastography (SWE) estimates shear modulus in muscle. This is interpreted as an index of muscle stiffness, but depends on muscle characteristics. This study evaluated relationship between shear modulus and myoelectric activity of lumbar multifidus and longissimus muscles to assess its validity. Intramuscular electromyography (EMG) of multifidus (deep [DM], superficial [SM] fibres) at L4/5, longissimus [LG] at L2, were recorded in nine healthy participants. Participants performed isometric trunk extension in side-lying from 0 to 30% maximal voluntary contraction (MVC) with EMG amplitude feedback. Using SWE, two regions of interest (ROI) were investigated in each muscle. Generally, shear modulus was moderately correlated with root mean squared (RMS) EMG (r = 0.50–0.78). Univariate and multiple regression analyses showed ultrasound/SWE features of ‘B-mode quality’ (24.5%), ‘%Void pixels’ (17.9%) and ‘Connective tissue’ (16.2%) explained most variation in the shear modulus/EMG relationship. Regression prediction scores generated using imaging features were correlated with r-coefficients of shear modulus/EMG relationship. When analysis was restricted to high quality data (i.e., regression prediction score above an a priori defined threshold), the shear modulus/EMG relationship increased to r = 0.70–0.96. Although a linear relationship between shear modulus/EMG was confirmed, supporting validity of SWE measures in anatomically distinct back muscles, this depends on image quality.