Intramuscular Perfusion Response in Delayed Onset Muscle Soreness (DOMS): A Quantitative Analysis with Contrast-Enhanced Ultrasound (CEUS)

The purpose of this study was to analyse intramuscular perfusion response in ultrastructural muscle lesions, by applying contrast-enhanced ultrasound (CEUS) to a delayed onset muscle soreness (DOMS) model. Results of this analysis were compared to high-resolution 3 Tesla MRI T2-weighted sequences. 14 healthy participants were recruited. Average perfusion parameters, represented as Peak enhancement (contrast agent inflow) and wash-in area under curve (WiAUC) of the gastrocnemius (GM) and soleus muscle (SM) were assessed before (baseline) and 60 h after inducing DOMS by eccentric exercise. Additionally, conventional ultrasound, high-resolution 3T MRI, creatine kinase level, range of motion (ROM) of the ankle joint, calf circumference and muscle soreness data were collected. Perfusion quantification revealed a statistically significant increase of intramuscular perfusion, corresponding to an increase in peak enhancement of 129.6 % (p = 0.0031) and in WiAUC of 115.2 % (p = 0.0107) in the gastrocnemius muscle at post-intervention. At follow-up, the MRI investigations showed intramuscular oedema for GM in all participants corresponding to a significant rise in T2 signal intensity (p = 0.001) and in T2 time value (p = 0.005). CEUS seems to be able to detect intramuscular perfusion changes and therefore may contribute to gaining deeper insight into the histopathology, inflammatory reactions and regeneration processes of ultrastructural muscle lesions.