Changes in calf muscle elasticity in hypogonadal males before and after testosterone substitution as monitored by magnetic resonance elastography.

PURPOSE We sought to determine whether differences in muscle elasticity between healthy age-related controls and patients with hypogonadism could be measured by a new, non-invasive method termed magnetic resonance elastography (MRE). MATERIALS AND METHODS Twelve hypogonadal (21-68 years) and twenty-seven healthy age-related men (20-76 years) were examined. In the hypogonadism group, serum testosterone levels were compared and MRE was conducted prior to and after 6 months of therapy in 6 of the 12 patients. MRE was performed by mechanically exciting the soleus muscle that was used because of its uniformly distributed muscle fibers, size, and accessibility, with a custom designed piezoelectric-actuator using a modified phase-contrast sequence. For mechanical excitation the actuator lever was placed on the anterior surface of the calf. The subjects had to maintain a force of 0-20% of their maximum voluntary contraction against a home-built footplate that was mounted on the MR table. All images were phase unwrapped and reconstructed into shear modulus elastograms using the local frequency estimation technique. RESULTS Testosterone levels were significantly higher after 6 months of treatment. A statistical difference in the shear modulus was observed prior to and after 6 months of testosterone therapy and was nearly the same as in the healthy age-related control group. CONCLUSION MRE seems to be a promising technique for the evaluation of therapeutic effects in patients with hypogonadism and possibly in other diseases with muscular effects.

[1]  Richard L Ehman,et al.  Determination of thigh muscle stiffness using magnetic resonance elastography , 2006, Journal of magnetic resonance imaging : JMRI.

[2]  K. An,et al.  Mechanical properties of relaxed and contracted thigh muscles using magnetic resonance elastography , 2005 .

[3]  Mark E Ladd,et al.  In vivo elasticity measurements of extremity skeletal muscle with MR elastography , 2004, NMR in biomedicine.

[4]  E. Nieschlag,et al.  Effects of androgen replacement on metabolism and physical performances in male hypogonadism , 2003, Journal of endocrinological investigation.

[5]  Mathias Fink,et al.  Transient elastography in anisotropic medium: application to the measurement of slow and fast shear wave speeds in muscles. , 2003, The Journal of the Acoustical Society of America.

[6]  U. Klose,et al.  Comparison of quantitative shear wave MR‐elastography with mechanical compression tests , 2003, Magnetic resonance in medicine.

[7]  Mark E. Ladd,et al.  Design of an MR‐compatible piezoelectric actuator for MR elastography , 2002 .

[8]  Richard L Ehman,et al.  Evaluation of healthy and diseased muscle with magnetic resonance elastography. , 2002, Archives of physical medicine and rehabilitation.

[9]  R. Casaburi,et al.  Testosterone-induced increase in muscle size in healthy young men is associated with muscle fiber hypertrophy. , 2002, American journal of physiology. Endocrinology and metabolism.

[10]  J. F. Greenleaf,et al.  Magnetic resonance elastography: Non-invasive mapping of tissue elasticity , 2001, Medical Image Anal..

[11]  L. Woodhouse,et al.  Proof of the effect of testosterone on skeletal muscle. , 2001, The Journal of endocrinology.

[12]  G. H. Rose,et al.  Magnetic resonance elastography of skeletal muscle , 2001, Journal of magnetic resonance imaging : JMRI.

[13]  N. Mauras,et al.  Journal of Clinical Endocrinology and Metabolism Printed in U.S.A. Copyright © 1998 by The Endocrine Society Testosterone Deficiency in Young Men: Marked Alterations in Whole Body Protein Kinetics, Strength, and Adiposity* , 2022 .

[14]  R. Casaburi,et al.  Testosterone replacement increases fat-free mass and muscle size in hypogonadal men. , 1997, The Journal of clinical endocrinology and metabolism.

[15]  D. Schoenfeld,et al.  Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism. , 1996, The Journal of clinical endocrinology and metabolism.

[16]  K. Nair,et al.  Effects of testosterone replacement on muscle mass and muscle protein synthesis in hypogonadal men--a clinical research center study. , 1996, The Journal of clinical endocrinology and metabolism.

[17]  Armando Manduca,et al.  Image processing for magnetic-resonance elastography , 1996, Medical Imaging.