Neuromuscular Ultrasonography: Quantifying Muscle and Nerve Measurements

Abstract

There is an inherent conflict between interpreting ultrasound imaging, which generates rich, highly textured complex representations of 3-dimensional space, and the rendering of these images into discrete measures for statistical analysis Reducing images to a small set of numbers, by necessity, ignores vast amounts of useful data, but the process is a prerequisite for generating objective information that can be shared by the clinical community. This article illustrates how ultrasound imaging is used in quantitative ways. The goal is not to supplant or diminish the importance of descriptive findings but to make the field amenable to statistical methods and standards for making diagnoses and designing therapeutic trials of new interventions. The discussion focuses first on muscle ultrasonography, a technique that was developed more than a decade earlier than nerve ultrasound, to illustrate key elements in determining how to best extract quantitative information from complex images. The discussion then applies some of these same principles to the study of 2 common nerve disorders.

The significance of muscle echo intensity on ultrasound for focal neuropathy: The median- to ulnar-innervated muscle echo intensity ratio in carpal tunnel syndrome

“…Normal muscle tissue is echolucent; hence, US is easily transmitted through the muscle tissue until reflection occurs at fibrous tissue (Mayans et al, 2012). However, muscle EI increases with fatty deposition and fibrous changes in the muscle (Pillen et al, 2009;Arts et al, 2010;Mayans et al, 2012). Muscle atrophy and replacement of muscle tissue with fat and collagen make muscle tissue heterogeneous in imaging studies (Maurits et al, 2003).…”

Multimodal Imaging of Sarcopenia using Optical Coherence Tomography and Ultrasound in Rat Model

“…Similarly, ultrasound provided overall muscle size that was measured along long and short axes in both healthy and atrophic TA muscles. Ultrasound indicated an apparent reduction of muscle size in both axes of the atrophic TA muscle compared with the healthy one (Data is not shown in this article) as previous studies had obtained [17]. When comparing histologic images of the healthy and atrophic TA muscles (Figs.…”

Assessment methods of body composition

“…Ultrasonografijom je moguće precizno izmeriti i debljinu mišićnog i koštanog tkiva podjednako efikasno kao i debljinu subkutanog i intraabdominalnog masnog tkiva [43]. Određivanje potkožnog i visceralnog masnog tkiva ultrazvukom se zasniva na emisiji ultrazvučnih talasa koji prodiru kroz kožu i strukture ispod nje.…”

“…Na graničnim površinama između tkiva različitih karakteristika, kao što su masno i mišićno tkivo dolazi do odbijanja ultrazvučnih talasa. Supkutano masno tkivo se može meriti na trbuhu kao i na mestima gde se meri uz pomoć kalipera [43].…”