Contrast-enhanced ultrasound shows muscle-repairing processes

Second-generation contrast agents reveal the healing process, as injured muscle tissue in professional athletes grows new blood vessels and repairs muscle damage. Ultrasound scans performed at regular intervals after injury allowed researchers to monitor the repair process and estimate when the athletes could safely return to full activity, potentially reducing relapses and complications.

Dr. Eugenio Annibale Genovese and colleagues in the radiology department of the University of Insubria in Varese, Italy, published their results in the July 26th issue of La Radiologia Medica. They examined 20 professional athletes - 18 men and two women - between the ages of 18 and 34 years old who presented with nine first-grade lesions and 11 second-grade lesions.

Patients received their first ultrasound exams within 48 hours of trauma. All exams were performed both with and without a contrast agent, using an Esaote Technos MPX scanner with a high-frequency linear probe. A second-generation agent, SonoVue, was injected intravenously.

Follow-up exams were performed 20, 40, and 60 days after trauma.

At the 20-day exam, contrast spots were observed over all or part of the lesion area. After 40 days, the contrast spots widened to include the entire scar area, with hemorrhagic residual in three cases. At the 60-day exam, no cases still showed any liquid hemorrhagic collection, and there was a significant reduction in the extent and intensity of vascular spots. In seven cases, the spots disappeared entirely.

The researchers concluded that the second-generation contrast agent allowed the identification of neoangiogenesis in damaged muscle, providing a method for recognition, individuation, and monitoring of the repair processes as new blood vessels formed. This, in turn, resulted in more specific follow-up care and accurate recommendations to athletes regarding their return to competitive physical activity.

The findings suggest that both relapses and complications should be reduced by having better information about the extent of the repair process in muscle lesions.