Quantitative diagnosis of early acute compartment syndrome by 2D-SWE in a rabbit model.
Jun Zhang1 , Kunlong Duan1, Junci Wei1, Wanfu Zhang2, Huihui Zhou1, Lin Sang1, Yuanyuan Sun1, Xue Gong1, Hao Guan2, Ming Yu1
1The department of Ultrasound, Xijing Hospital, The Air Force Medical University, Xi’an, China
2The department of Burns and Cutaneous Surgery, Xijing Hospital, The Air Force Medical University, Xi’an, China
Corresponding Author: Ming Yu ,Tel: 02984775447, Fax: 02984775447, Email: yumingfmmu@126.com
Received: April 17, 2024;  Accepted: July 7, 2024.  Published online: July 7, 2024.
ABSTRACT
Purpose:
To investigate the relationship between the elasticity modulus/ the shear wave velocity of the tibialis anterior muscle and the intracompartmental pressure (ICP) in a New Zealand rabbit model of acute compartment syndrome (ACS), and to further explore whether 2D-SWE can be used as a new non-invasive method for early diagnosis of ACS.
Methods:
The direct external compression ACS models were created by applying pressure bandaging to the lower legs of fifteen New Zealand rabbits using neonatal blood pressure cuffs, with an additional five animals serving as a non-modeled control group. The elasticity modulus and shear wave velocity of the tibialis anterior muscles pre- and post-modeling were measured. ICP in the anterior tibial compartment was determined using the Whitesides method. Blood oxygen saturation, serum creatine kinase and myoglobin levels were monitored throughout the experiment. Subsequently, the anterior tibial muscle was extracted for hematoxylin and eosin (H&E) staining to assess muscle damage.
Results:
A strong positive correlation was observed between ICP and these above indices, particularly ICP and mean velocity (r=0.9421, P<0.0001) and ICP and creatine kinase (r=0.9424, P<0.0001). Blood oxygen saturation exhibited a negative correlation with ICP (r=-0.8865, P<0.0001). Histological examination revealed an increase in muscle cell swelling over time, with damage progressing from reversible to irreversible, ultimately leading to muscle cell necrosis.
Conclusion:
2D-SWE has the potential to serve as a novel tool for assessing the initial phases of acute compartment syndrome, offering a quantitative foundation for clinical diagnosis.
Keywords: Acute Compartment Syndrome; Intra-compartment Pressure; Ultrasound 2D Shear-wave Elastography; Animal Model
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