Exercise Dependent Changes in Periosteal Femur Perfusion

Schroeter S, Rueter L, Heiß R, Hammer C, Lutter C, Hoppe MW, Grim C, Engelhardt M, Hotfiel T (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Sport-Orthopädie, Sport-Traumatologie Elsevier

DOI: 10.1016/j.orthtr.2021.11.010

Abstract

Background: Contrast-enhanced ultrasound (CEUS) has been shown to be a valid measurement tool for evaluating microvascular blood flow. Until now, the assessment of periosteal tissue has been insufficiently validated, and a procedure has not yet been standardized for this purpose. The aim of the present study was to investigate periosteal femur perfusion in the context of cycling exercise by means of CEUS and to evaluate the feasibility and reliability of this method. Material and Methods: Seventeen healthy athletes were recruited as study participants for the evaluation of periosteal femur perfusion (FP) and vastus intermedius muscle (VI) by CEUS (bolus dosage of 2.7 ml contrast agent, Sonovue, Bracco, Italy). Data were acquired from participants under resting conditions (T0) and immediately after standardized cycling exercise (T1, 20 min, 70% of maximum capacity). Peak enhancement (PE), the wash-in rate (WiR), the wash-in area under the curve (WiAUC), and the wash-in perfusion index (WiPI) were determined by software-based mapping quantification (Vuebox, Bracco, Italy). Intra- and interrater reliability were assessed among three different measurement time points and two investigators. Results: After exercise, a significant perfusion increase in the femur periosteum of 101.8% (PE; p = 0.003), 176.7% (WiR; p = 0.02), 93% (WiAUC; p< 0.001) and 116.2% (WiPI; p< 0.001) was observed in all measurement parameters compared to the resting conditions. For the VI, the increase was 110.9% (PE; p = 0.003), 221.3% (WiR; p< 0.001), 49.1% (WiAUC; p = 0.03), and 120.4% (WiPI; p< 0.001). Intrarater reliability showed measurement errors of 3.2–3.4% (PE), 5.0–5.1% (WiR), 4.5–4.1% (WiAUC), and 4.5–6.1% (WiPI). Interrater reliability presented measurement errors that ranged from 5.0–7.0% for T0 and 3.3–5.5% for T1. Conclusions: Lower limb exercise with a moderate load (ergometer cycling) significantly enhanced perfusion in healthy athletes within the FP and VI. Our data support the implementation of moderate exercise if enhanced tissue circulation is required. The findings from this study show that performing CEUS on the FP is a valuable diagnostic modality with high intra- and interrater reliability.

Authors with CRIS profile

Rafael Heiß Institute of Radiology Christian Hammer Lehrstuhl für Funktionelle und Klinische Anatomie

Involved external institutions

Klinikum Osnabrück DE Germany (DE) Universität Leipzig DE Germany (DE) Universitätsmedizin Rostock DE Germany (DE)

How to cite

APA:

Schroeter, S., Rueter, L., Heiß, R., Hammer, C., Lutter, C., Hoppe, M.W.,... Hotfiel, T. (2022). Exercise Dependent Changes in Periosteal Femur Perfusion. Sport-Orthopädie, Sport-Traumatologie. https://doi.org/10.1016/j.orthtr.2021.11.010

MLA:

Schroeter, S., et al. "Exercise Dependent Changes in Periosteal Femur Perfusion." Sport-Orthopädie, Sport-Traumatologie (2022).

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