Restoration of muscle volume and shape induced by electrical stimulation of denervated degenerated muscles: qualitative and quantitative measurement of changes in rectus femoris using computer tomography and image segmentation.

This study demonstrates in a novel way how volume and shape are restored to denervated degenerated muscles due to a special pattern of electrical stimulation. To this purpose, Spiral Computer Tomography (CT) and special image processing tools were used to develop a method to isolate the rectus femoris from other muscle bellies in the thigh and monitor growth and morphology changes very accurately. During 4 years of electrical stimulation, three-dimensional (3D) reconstructions of the rectus femoris muscles from patients with long-term flaccid paraplegia were made at different points in time. The growth of the muscle and its changes through the time period are seen in the 3D representation and are measured quantitatively. Furthermore, changes in shape are compared with respect to healthy muscles in order to estimate the degree of restoration. The results clearly show a slow but continuing muscle growth induced by electrical stimulation; the increase of volume is accompanied by the return of a quasi-normal muscle shape. This technique allows a unique way of monitoring which provides qualitative and quantitative information on the denervated degenerated muscle behavior otherwise hidden.

Monitoring muscle growth and tissue changes induced by electrical stimulation of denervated degenerated muscles with CT and stereolithographic 3D modeling.

In the frame of the EU-funded RISE project, patients with lower motor neuron lesion and denervated and degenerated muscles are treated with electrical stimulation, with the aim of restoring muscle mass and force. Spiral computer tomography from the hip joint down to the knee joint is used to gather three-dimensional data on the upper leg tissue. These data are analyzed in order to monitor tissue changes induced by the electrical stimulation treatment. Especially the data representing muscle tissue and bone tissue were isolated for measurement purposes. Computer models and models made with rapid prototyping methods were used to display and demonstrate changes in muscle shape and size, as well as position relative to bone. Results showed that time and spatial dependencies of muscle growth can be monitored and studied quantitatively and qualitatively with the aid of a three-dimensional data set displayed on the computer screen or in the form of plastic models. These first results indicate muscle growth and an increase in bone density.