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ORIGINAL ARTICLE
Year : 2022  |  Volume : 10  |  Issue : 1  |  Page : 8-12

Quantitative analysis of masseter muscle hardness with shear-wave elastography: Preliminary study on comparison between during rest and contraction in young adults


1 Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and Histopathological Diagnostics, Course of Applied Science, The Nippon Dental University Graduate School of Life Dentistry At Niigata, Chuo-Ku, Niigata, Japan
2 Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and Histopathological Diagnostics, Course of Applied Science; Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry At Niigata, Chuo-Ku, Niigata, Japan

Date of Submission14-Feb-2022
Date of Decision21-Mar-2022
Date of Acceptance23-Mar-2022
Date of Web Publication21-Apr-2022

Correspondence Address:
Yoshiyuki Minami
Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and AHistopathological Diagnostics, Course of Applied Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, 1-8 Hamaura-cho, Chuo-Ku, Niigata, Niigata 951-8580
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jomr.jomr_3_22

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  Abstract 


Background: Ultrasound examination is one of the widespread diagnostic imaging methods and still a developing method, which underwent an intense development for biomechanical evaluation of muscles important in temporomandibular disorders, muscle injuries, and training. Aims: This study aims to analyze masseter muscle hardness with shear-wave elastography, especially comparison between during rest and contraction in young adults. Materials and Methods: Thirty-seven volunteers (20 men and 17 women; mean age 25.0 years [age 22–43 years]) were examined by shear-wave elastography with a 14-MHz linear transducer. The shear elastic modulus and thickness of masseter muscles with ultrasonography were compared between during rest and contraction, and between men and women using Mann–Whitney U-test. The statistical analysis of the relationships between contraction and during rest was compared using Wilcoxon signed-rank sum test. P < 0.05 indicates significant differences. Results: Shear elastic modulus data of masseter muscles at contraction were significantly higher than those at during rest (P < 0.001). The thickness of masseter muscles at contraction was significantly higher than those at during rest (P < 0.001). Shear elastic modulus data of masseter muscles at during rest were not a significant difference between men and women (P = 0.402). Similarly, shear elastic modulus data of masseter muscles at contraction were not a significant difference between men and women (P = 0.223). Conclusions: Shear-wave elastography could be an effective tool for the quantitative analysis of masseter muscle hardness.

Keywords: Elastic modulus, masseter muscle, shear-wave elastography, ultrasonography


How to cite this article:
Minami Y, Ogura I. Quantitative analysis of masseter muscle hardness with shear-wave elastography: Preliminary study on comparison between during rest and contraction in young adults. J Oral Maxillofac Radiol 2022;10:8-12

How to cite this URL:
Minami Y, Ogura I. Quantitative analysis of masseter muscle hardness with shear-wave elastography: Preliminary study on comparison between during rest and contraction in young adults. J Oral Maxillofac Radiol [serial online] 2022 [cited 2022 May 21];10:8-12. Available from: https://www.joomr.org/text.asp?2022/10/1/8/343692




  Introduction Top


In recent years, ultrasound examination is one of the widespread diagnostic imaging methods and still a developing method, which underwent an intense development for biomechanical evaluation of muscles important in temporomandibular disorders, muscle injuries, and training. When muscle fibers are damaged, muscles show shortening and hardening.[1],[2],[3],[4] Exercise changes muscle hardness and thickness.[1],[2] The hardness of the masticatory muscles can aid in the diagnosis and treatment of myalgia in patients with temporomandibular disorders.[5],[6],[7],[8]

The types of sonoelastography include strain-type sonoelastography and shear-wave sonoelastography.[9] Strain-type sonoelastography is an operator dependency and a low reproducibility evaluation.[10],[11],[12],[13],[14],[15] Shear-wave elastography uses push pulses to stress tissues and an ultrafast ultrasound imaging technique to detect the induced shear waves.[16],[17],[18] It is easier to perform than elastography requiring manual compression, and the results of the examination are more repeatable. Shear-wave sonoelastography is expected to lead to a reduction in operator dependency, high reproducibility, and quantitative evaluation.[19],[20],[21],[22],[23],[24],[25],[26],[27] However, the current evidence in normal masticatory muscles is weak, and the clinical usefulness of such information is still unclear. The aim of this study was to analyze masseter muscle hardness with shear-wave elastography, especially comparison between during rest and contraction in young adults.


  Materials And Methods Top


Subjects

This study was approved by the ethics committee of our institution (ECNG-R-400). All volunteers provided written informed consent. Thirty-seven volunteers (20 men and 17 women; mean age 25.0 years [age 22–43 years]) were examined by shear-wave elastography with a 14-MHz linear transducer at our university hospital from November 2020 to February 2021. The volunteers were our student doctor with healthy and had no missing teeth without wisdom tooth and had no severe medical history or symptoms.

Shear-wave elastography

A conventional ultrasonography examination (grayscale and power Doppler ultrasonography) and shear-wave elastography were performed using a 14-MHz loner transducer (Aplio300, Cannon Medicals Systems, Otawara, Japan) by two oral and maxillofacial radiologists, following our institutional protocol.[28] We used scan gel (ELK; Canon Life Solutions, Tokyo, Japan). The integrated shear-wave elastography software allowed the operator to place region of interest (ROIs) within the elastography window and automatically displayed shear elastic modulus data (kPa) for each ROI at during rest and contraction, respectively [Figure 1] and [Figure 2]. The thickness of masseter muscles (mm) using ultrasonography was measured at masseter muscles and maximum diameter at during rest and maximum force contraction, respectively. The volunteer's set position is sitting position on dental unit. The location for measurements is center of vertical length and front-back width. Shear elastic modulus data and thickness were average of measurements three times.
Figure 1: Masseter muscles at during rest with shear-wave elastography

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Figure 2: Masseter muscle at contraction with shear-wave elastography

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Statistical analysis

The coefficient of determination (R2) from the analyses was calculated to evaluate the relationship between thickness contraction and during rest of masseter muscle. The shear elastic modulus and thickness of masseter muscles were compared between during rest and contraction and between men and women using the Mann–Whitney U-test. The statistical analysis of the relationships between contraction and during rest was compared using the Wilcoxon signed-rank sum test. All analyses were performed with IBM SPSS Statistics Statistical Package version 26 (IBM Japan, Tokyo, Japan). P < 0.05 represented statistical significance.


  Results Top


[Table 1] shows the shear elastic modulus data and thickness of masseter muscles at during rest and contraction. Shear elastic modulus data of masseter muscles at contraction (147.6 ± 25.3 kPa) were significantly higher than those at during rest (27.2 ± 12.6 kPa, P < 0.001). The thickness of masseter muscles at contraction (13.1 ± 2.5 mm) was significantly higher than those at during rest (9.9 ± 2.7 mm, P < 0.001).
Table 1: The shear elastic modulus data and thickness of masseter muscles at during rest and contraction

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[Table 2] shows those at shear elastic modulus data and thickness of masseter muscles at during rest and contraction in men and women. Shear elastic modulus data of masseter muscles at during rest were not a significant difference between men and women (P = 0.402). Similarly, shear elastic modulus data of masseter muscles at contraction were not a significant difference between men and women (P = 0.223). However, the thickness of masseter muscles at during rest of men (11.2 ± 2.6 mm) was significantly higher than those of women (8.4 ± 2.0 mm, P = 0.001). Furthermore, the thickness of masseter muscles at contraction of men (14.5 ± 2.2 mm) was significantly higher than those of women (11.5 ± 1.8 mm, P < 0.001).
Table 2: Shear elastic modulus data and thickness of masseter muscles at during rest and contraction on comparison between men and women in young adults

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We plotted during rest (X) against contraction (Y) and observed no significant correlation at shear elastic modulus data (Y = ‒0.161X + 152.029 [R2 = 0.007, P = 0.633]; [Figure 3]). Similarly, we plotted during rest (X) against contraction (Y) and observed a significant correlation at thickness of masseter muscles (Y = 0.781X + 5.403 [R2 = 0.687, P < 0.001]; [Figure 4]).
Figure 3: Relationships between contraction and during rest at shear elastic modulus data of masseter muscles

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Figure 4: Relationships between contraction and during rest at thickness of masseter muscles

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  Discussion Top


Shear-wave sonoelastography is inexpensive, easy to use, noninvasive, takes a short time, and has no adverse effects compared to other prominent methods of medical imaging. This study demonstrated the effectiveness of shear-wave elastography of the masseter muscles.

Ariji et al.[9] showed significantly difference that the mean hardness on shear-wave sonoelastography was 42.82 ± 5.56 kPa at rest and 53.86 ± 8.26 kPa during jaw clenching. In this study, the mean hardness was 27.2 ± 12.6 kPa at rest and 147.6 ± 25.3 kPa at contraction (P < 0.001). Furthermore, shear elastic modulus data at during rest and contraction were no significant differences between men and women. Arda et al.[29] showed hardness of the masseter muscle of healthy volunteers in the supine position, and the result was 10.4 kPa. In this study, the mean hardness of the masseter muscle of healthy volunteers using shear-wave sonography was 27.2 ± 12.6 kPa at rest and 147.6 ± 25.3 kPa at contraction in sitting position on dental unit. The discrepancy between the three studies would be due to the differences in sex distribution of the subject, race, device, software, and measurement methods and ROI.

Hara et al.[30] showed that masseter muscle stiffness is effective to assess tooth loss as well as an index of masseter muscle strength when evaluating maximum bite force and that there was no difference between men and women, except for masseter muscle thickness during rest (P = 0.001) and masseter muscle thickness during forceful biting (P = 0.001). In this study, thickness at contraction (13.1 ± 2.5 mm) was significantly higher than during rest (9.9 ± 2.7 mm, P < 0.001). Our study was a significant difference in thickness of masseter muscles depend on sex, but no significant difference in shear elastic modulus data depends on sex. We infer that muscle function influences the thickness of masseter muscles and muscle mass influence shear elastic modulus data.


  Conclusion Top


There are several limitations to our study. In future, it will be necessary to increase the number of cases and to examine the relationship masseter muscle thickness, shear-wave sonoelastography maximum bite force, masticatory function, and aging. In conclusion, we analyzed masseter muscle hardness with shear-wave elastography, especially a comparison between during rest and contraction in young adults. The results of the present study indicate that shear-wave elastography could be an effective tool for the quantitative analysis of masseter muscle hardness.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Yanagisawa O, Niitsu M, Kurihara T, Fukubayashi T. Evaluation of human muscle hardness after dynamic exercise with ultrasound real-time tissue elastography: A feasibility study. Clin Radiol 2011;66:815-9.  Back to cited text no. 1
    
2.
Murayama M, Nosaka K, Yoneda T, Minamitani K. Changes in hardness of the human elbow flexor muscles after eccentric exercise. Eur J Appl Physiol 2000;82:361-7.  Back to cited text no. 2
    
3.
Fischer AA. Clinical use of tissue compliance meter for documentation of soft tissue pathology. Clin J Pain 1987;3:23-30.  Back to cited text no. 3
    
4.
Clarkson PM, Nosaka K, Braun B. Muscle function after exercise-induced muscle damage and rapid adaptation. Med Sci Sports Exerc 1992;24:512-20.  Back to cited text no. 4
    
5.
Hiraiwa Y, Ariji Y, Kise Y, Sakuma S, Kurita K, Ariji E. Efficacy of massage treatment technique in masseter muscle hardness: Robotic experimental approach. Cranio 2013;31:291-9.  Back to cited text no. 5
    
6.
Ariji Y, Gotoh A, Hiraiwa Y, Kise Y, Nakayama M, Nishiyama W, et al. Sonographic elastography for evaluation of masseter muscle hardness. Oral Radiol 2013;29:64-9.  Back to cited text no. 6
    
7.
Gotoh A, Ariji Y, Hasegawa T, Nakayama M, Kise Y, Matsuoka M, et al. Sonographic elastography for assessing changes in masseter muscle elasticity after low-level static contraction. Oral Radiol 2013;29:140-5.  Back to cited text no. 7
    
8.
Ariji Y, Nakayama M, Nishiyama W, Ogi N, Sakuma S, Katsumata A, et al. Can sonographic features be efficacy predictors of robotic massage treatment for masseter and temporal muscle in patients with temporomandibular disorder with myofascial pain? Cranio 2016;34:13-9.  Back to cited text no. 8
    
9.
Ariji Y, Nakayama M, Nishiyama W, Nozawa M, Ariji E. Shear-wave sonoelastography for assessing masseter muscle hardness in comparison with strain sonoelastography: Study with phantoms and healthy volunteers. Dentomaxillofac Radiol 2016;45:20150251.  Back to cited text no. 9
    
10.
Chino K, Akagi R, Dohi M, Fukashiro S, Takahashi H. Reliability and validity of quantifying absolute muscle hardness using ultrasound elastography. PLoS One 2012;7:e45764.  Back to cited text no. 10
    
11.
Sebag F, Vaillant-Lombard J, Berbis J, Griset V, Henry JF, Petit P, et al. Shear wave elastography: A new ultrasound imaging mode for the differential diagnosis of benign and malignant thyroid nodules. J Clin Endocrinol Metab 2010;95:5281-8.  Back to cited text no. 11
    
12.
Yoshii Y, Ishii T, Etou F, Sakai S, Tanaka T, Ochiai N. Reliability of automatic vibratory equipment for ultrasonic strain measurement of the median nerve. Ultrasound Med Biol 2014;40:2352-7.  Back to cited text no. 12
    
13.
Fruscalzo A, Schmitz R, Klockenbusch W, Steinhard J. Reliability of cervix elastography in the late first and second trimester of pregnancy. Ultraschall Med 2012;33:E101-7.  Back to cited text no. 13
    
14.
Ozkan F, Yavuz YC, Inci MF, Altunoluk B, Ozcan N, Yuksel M, et al. Interobserver variability of ultrasound elastography in transplant kidneys: Correlations with clinical-Doppler parameters. Ultrasound Med Biol 2013;39:4-9.  Back to cited text no. 14
    
15.
Oxborough D, George K, Birch KM. Intraobserver reliability of two-dimensional ultrasound derived strain imaging in the assessment of the left ventricle, right ventricle, and left atrium of healthy human hearts. Echocardiography 2012;29:793-802.  Back to cited text no. 15
    
16.
Bhatia KS, Cho CC, Tong CS, Lee YY, Yuen EH, Ahuja AT. Shear wave elastography of focal salivary gland lesions: Preliminary experience in a routine head and neck US clinic. Eur Radiol 2012;22:957-65.  Back to cited text no. 16
    
17.
Bhatia KS, Tong CS, Cho CC, Yuen EH, Lee YY, Ahuja AT. Shear wave elastography of thyroid nodules in routine clinical practice: Preliminary observations and utility for detecting malignancy. Eur Radiol 2012;22:2397-406.  Back to cited text no. 17
    
18.
Dieterich AV, Andrade RJ, Le Sant G, Falla D, Petzke F, Hug F, et al. Shear wave elastography reveals different degrees of passive and active stiffness of the neck extensor muscles. Eur J Appl Physiol 2017;117:171-8.  Back to cited text no. 18
    
19.
Yoshitake Y, Takai Y, Kanehisa H, Shinohara M. Muscle shear modulus measured with ultrasound shear-wave elastography across a wide range of contraction intensity. Muscle Nerve 2014;50:103-13.  Back to cited text no. 19
    
20.
Athanasiou A, Tardivon A, Tanter M, Sigal-Zafrani B, Bercoff J, Deffieux T, et al. Breast lesions: Quantitative elastography with supersonic shear imaging – Preliminary results. Radiology 2010;256:297-303.  Back to cited text no. 20
    
21.
Vergari C, Rouch P, Dubois G, Bonneau D, Dubousset J, Tanter M, et al. Non-invasive biomechanical characterization of intervertebral discs by shear wave ultrasound elastography: A feasibility study. Eur Radiol 2014;24:3210-6.  Back to cited text no. 21
    
22.
Hudson JM, Milot L, Parry C, Williams R, Burns PN. Inter- and intra-operator reliability and repeatability of shear wave elastography in the liver: A study in healthy volunteers. Ultrasound Med Biol 2013;39:950-5.  Back to cited text no. 22
    
23.
Bhatia K, Tong CS, Cho CC, Yuen EH, Lee J, Ahuja AT. Reliability of shear wave ultrasound elastography for neck lesions identified in routine clinical practice. Ultraschall Med 2012;33:463-8.  Back to cited text no. 23
    
24.
Barr RG. Shear wave liver elastography. Abdom Radiol (NY) 2018;43:800-7.  Back to cited text no. 24
    
25.
Zemanova M. Shear wave elastography in ophthalmic diagnosis. J Fr Ophtalmol 2019;42:73-80.  Back to cited text no. 25
    
26.
Costa YM, Ariji Y, Ferreira DM, Bonjardim LR, Conti PC, Ariji E, et al. Muscle hardness and masticatory myofascial pain: Assessment and clinical relevance. J Oral Rehabil 2018;45:640-6.  Back to cited text no. 26
    
27.
Sedlackova Z, Herman J, Furst T, Salzman R, Vachutka J, Herman M. Shear wave elastography in diffuse thyroid disease. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2021;165:152-6.  Back to cited text no. 27
    
28.
Sasaki Y, Ogura I. Shear wave elastography in differentiating between benign and malignant cervical lymph nodes in patients with oral carcinoma. Dentomaxillofac Radiol 2019;48:20180454.  Back to cited text no. 28
    
29.
Arda K, Ciledag N, Aktas E, Aribas BK, Köse K. Quantitative assessment of normal soft-tissue elasticity using shear-wave ultrasound elastography. AJR Am J Roentgenol 2011;197:532-6.  Back to cited text no. 29
    
30.
Hara K, Namiki C, Yamaguchi K, Kobayashi K, Saito T, Nakagawa K, et al. Association between myotonometric measurement of masseter muscle stiffness and maximum bite force in healthy elders. J Oral Rehabil 2020;47:750-6.  Back to cited text no. 30
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1], [Table 2]



 

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