Muscle‐ultrasound evaluation in healthy pediatric subjects: Age‐related normative data

Lori, S.; Lolli, Francesco; Molesti, E.; Bastianelli, M.; Gabbanini, S.; Saia, Valentina; Trapani, S.; Marinoni, Marinella

doi:10.1002/mus.26151

Cited by 11 publications

(17 citation statements)

References 17 publications

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“…The significant correlation between age and muscle architecture parameters found in this study is consistent with a previous report [13] that showed that pennation angle values increase from birth and stabilize after adolescence. Our results are also consistent with another study [14] wherein it was found that the muscle thickness increases with age from 2 to 16 years in healthy children. The increase in the muscle architecture parameters with age may be due to the ongoing maturation and development of children as the muscle size increases.…”

Section: Discussionsupporting

confidence: 93%

Correlation between age, muscle architecture, and muscle strength in children with Erb’s palsy

2021

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Background Muscle weakness is a widespread problem in children with Erb’s palsy as it can cause changes in muscle architecture parameters, which can be detected by ultrasonography. This study was conducted to determine the relation between age, muscle architecture, and muscle strength in children with Erb’s palsy. A total of 40 children with Erb’s palsy from both sexes aged 1–2.5 years were included in this study. Muscle thickness and pennation angle were measured by ultrasonography, and muscle strength was measured using the active movement scale. Results A significant relation was found between age, muscle thickness, pennation angle, and muscle strength (P < 0.05). Moreover, a significant difference was found in muscle architecture parameters during relaxation and contraction in both study groups and in each study group (P < 0.05). Conclusion Muscle weakness in children with Erb’s palsy has an effect on muscle architecture parameters, and these parameters also increase with age.

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Section: Discussionsupporting

confidence: 93%

Correlation between age, muscle architecture, and muscle strength in children with Erb’s palsy

2021

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“…The systematic difference in echodensity between mechanically ventilated patients and healthy subjects may arise from differences in age or chronic comorbidity between groups, apart from any acute muscle injury in mechanically ventilated patients. Both comorbidity and age have been shown to affect muscle echodensity [8,28,40]. These factors might account for some of the observed differences between patients and healthy subjects in this study; to mitigate confounding in this comparison, we analyzed the change in echodensity within subjects over time and normalized patients to their baseline echodensity.…”

Section: Discussionmentioning

confidence: 99%

Diaphragm echodensity in mechanically ventilated patients: a description of technique and outcomes

et al. 2021

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Background Acute increases in muscle sonographic echodensity reflect muscle injury. Diaphragm echodensity has not been measured in mechanically ventilated patients. We undertook to develop a technique to characterize changes in diaphragm echodensity during mechanical ventilation and to assess whether these changes are correlated with prolonged mechanical ventilation. Methods Diaphragm ultrasound images were prospectively collected in mechanically ventilated patients and in 10 young healthy subjects. Echodensity was quantified based on the right-skewed distribution of grayscale values (50th percentile, ED50; 85th percentile, ED85). Intra- and inter-analyzer measurement reproducibility was determined. Outcomes recorded included duration of ventilation and ICU complications (including reintubation, tracheostomy, prolonged ventilation, or death). Results Echodensity measurements were obtained serially in 34 patients comprising a total of 104 images. Baseline (admission) diaphragm ED85 was increased in mechanically ventilated patients compared to younger healthy subjects (median 56, interquartile range (IQR) 42–84, vs. 39, IQR 36–52, p = 0.04). Patients with an initial increase in median echodensity over time (≥ + 10 in ED50 from baseline) had fewer ventilator-free days to day 60 (n = 13, median 46, IQR 0–52) compared to patients without this increase (n = 21, median 53 days, IQR 49–56, unadjusted p = 0.03). Both decreases and increases in diaphragm thickness during mechanical ventilation were associated with increases in ED50 over time (adjusted p = 0.03, conditional R2 = 0.80) and the association between increase in ED50 and outcomes persisted after adjusting for changes in diaphragm thickness. Conclusions Many patients exhibit increased diaphragm echodensity at the outset of mechanical ventilation. Increases in diaphragm echodensity during the early course of mechanical ventilation are associated with prolonged mechanical ventilation. Both decreases and increases in diaphragm thickness during mechanical ventilation are associated with increased echodensity.

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“…Although we are reluctant to over-interpret these findings, it is tempting to hypothesize that these muscles could still reveal the same developmental trend, after a short delay. For instance, in this respect Lori et al had reported that biceps and tibialis anterior muscles do reveal an MUD increase, after the 2 nd year of life [20]. However, additional data are needed to substantiate this hypothesis to further extent.…”

Section: Fetal-mud-ratiomentioning

confidence: 92%

“…All lengths and weights of the included fetuses and newborns were within the normal range of the prenatal Hadlock growth curve and the postnatal growth curve [22]. Since weight and length of healthy children do not influence MUD [15,20], individual values are not specified. For personal reasons related to traveling and domestic zest, parents of eight fetally included children decided to stop with their longitudinal participation after delivery.…”

Section: Participantsmentioning

confidence: 99%

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Development of muscle ultrasound density in healthy fetuses and infants

et al. 2020

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Muscle ultrasound density (MUD) is a non-invasive parameter to indicate neuromuscular integrity in both children and adults. In healthy fetuses and infants, physiologic MUD values during development are still lacking. We therefore aimed to determine the physiologic, agerelated MUD trend of biceps, quadriceps, tibialis anterior, hamstrings, gluteal and calf muscles, from pre-to the first year of postnatal life. To avoid a bias by pregnancy-related signal disturbances, we expressed fetal MUD as a ratio against bone ultrasound density. We used the full-term prenatal MUD ratio and the newborn postnatal MUD value as reference points, so that MUD development could be quantified from early pre-into postnatal life. Results: During the prenatal period, the total muscle group revealed a developmental MUD trend concerning a fetal increase in MUD-ratio from the 2 nd trimester up to the end of the 3 rd trimester [median increase: 27% (range 16-45), p < .001]. After birth, MUD-values increased up to the sixth month [median increase: 11% (range-7-27), p = 0.025] and stabilized thereafter. Additionally, there were also individual MUD characteristics per muscle group and developmental stage, such as relatively low MUD values of fetal hamstrings and high values of the paediatric gluteus muscles. These MUD trends are likely to concur with analogous developmentally, maturation-related alterations in the muscle water to peptide content ratios.

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Muscle‐ultrasound evaluation in healthy pediatric subjects: Age‐related normative data

Abstract: Our MUS study provides new data on physiological muscle structural changes in healthy children to address the limited available references in this age group. Muscle Nerve 58: 245-250, 2018.

Cited by 11 publications

References 17 publications

Correlation between age, muscle architecture, and muscle strength in children with Erb’s palsy

Correlation between age, muscle architecture, and muscle strength in children with Erb’s palsy

Diaphragm echodensity in mechanically ventilated patients: a description of technique and outcomes

Development of muscle ultrasound density in healthy fetuses and infants

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