Magnetic resonance elastography studies of human skeletal muscle
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A robust, reliable method to non-invasively measure in-vivo mechanical properties of large tissue areas was unavailable until the advent of a new Magnetic Resonance Imaging (MRI) technique known as Magnetic Resonance Elastography (MRE). MRE is a phase-contrast imaging technique that enables quantification of tissue mechanical properties by capturing the motion of induced shear waves via a synchronised Motion Encoding Gradient (MEG). The complex shear modulus is determined via mathematical inversion and reported as the magnitude of the complex shear modulus, |G*|, and phase angle, φ. The work reported in this thesis focuses on the development of MRE data acquisition and analysis protocols optimised to study thigh muscle mechanical properties. The protocols are subsequently applied in healthy volunteers to study natural phenomena such as contraction and ageing and interventions such as an experimental protocol to produce Exercise Induced Muscle Damage (EIMD). Methodological advances made throughout this work include moving from 2D to 3D MRE data acquisition protocols and the application of advanced inversion software to extract muscle viscoelastic properties from the acquired MRE data. Results obtained include observation of reduced muscle stiffness in 6 elderly subjects (>80 years old) compared to 4 young subjects in the Vastus Lateralis (32%), quadriceps muscle group (22%) and entire thigh cross-section (19%), higher resting stiffness of agonist quadriceps compared to antagonist hamstrings (18%) and an increase in quadriceps stiffness (40%) during a leg raise task in 11 healthy subjects. Variability in muscle group recruitment patterns during the contraction were also observed, with the phase angle of the Vastus Intermedius (VI) increasing significantly during contraction. The final experiment involved the recruitment of 20 healthy male subjects to perform an eccentric exercise protocol designed to induce EIMD. Subjects who displayed a Maximum Voluntary Contraction (MVC) force deficit of >10% were considered to have experienced EIMD. A further severe EIMD group were defined based on the presence of hyper-intense signal on T2 weighted imaging following the protocol. The T2 hyper-intensity was found to occur exclusively in the Rectus Femoris (RF) and VI muscle groups. Increased muscle stiffness was observed in the RF muscle in subjects who experienced moderate EIMD (6%). A greater increase in RF stiffness (48%) was observed in the severe EIMD group. The severe EIMD group also displayed significantly increased VI stiffness (14%). The experiments carried out provide several novel findings which can support the development of beneficial strategies to promote both healthy ageing and rehabilitation in athletes, and potentially contribute to improving muscle performance evaluation tests which will expand the opportunities for clinical applications of muscle MRE.