Skeletal muscle sonography: a correlative study of echogenicity and morphology

Reimers, Kerstin; Reimers, Carl D.; Wagner, Stefan; Paetzke, I.; Pongratz, D.

doi:10.7863/jum.1993.12.2.73

Cited by 332 publications

(274 citation statements)

References 3 publications

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“…The advantages of US are that it is noninvasive as well as less expensive and more portable than other medical imaging modalities such as magnetic resonance imaging, computed tomography, and dual-energy X-ray absorptiometry. The reliability and validity of MT and EI have been confirmed in the literature [19,21,24,26,28,29]. MT is positively associated with the muscle size and is thus used as an index of muscle quantity [24,25].…”

mentioning

confidence: 59%

Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients

Maeda

Imada²,

Ishida

et al. 2019

Eur Neurol

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Introduction: Quadriceps muscle atrophy and quality loss, defined as an increased ratio of intramuscular fat and/or connective tissue, are often observed especially in the paretic limb of post-stroke patients. This study was performed to examine the relationship of quadriceps muscle thickness (MT) with muscle echo intensity (EI) and the severity of motor paralysis after stroke. Methods: Thirty-six hemiparetic subacute post-stroke patients were enrolled. We examined the MT (index of muscle quantity) and the EI (index of muscle quality) at the anterior mid-thigh in both limbs. We also assessed the Brunnstrom stage (BR stage), subcutaneous adipose tissue thickness, time since stroke, age, body weight, sex, number of medications, and nutritional and inflammation status. Results: The MT in the paretic limb was explained by the BR stage (β = –0.26, p < 0.01), body weight (β = 0.68, p < 0.01), and serum albumin (β = 0.34, p < 0.01), with an adjusted R² of 0.81. The MT in the non-paretic limb was explained by the muscle EI (β = –0.55, p < 0.01) and age (β = –0.40, p < 0.01), with an adjusted R² of 0.69. The muscle EI was explained by the MT in the paretic limb (β = –0.34, p < 0.01) and non-paretic limb (β = –0.69, p < 0.01). Conclusions: Our results suggest that motor paralysis, aging, and malnutrition contribute to quadriceps atrophy in post-stroke patients. Moreover, a potential countermeasure to diminish muscle quality loss is maintenance of muscle quantity.

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mentioning

confidence: 59%

Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients

Maeda

Imada²,

Ishida

et al. 2019

Eur Neurol

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“…There is also an increase in body fat [13]. Normally, subcutaneous fat, water and skeletal muscle fibres are hypoechoeic, but infiltration of skeletal muscles by fat results in increased muscular EI [15]. This may be due to a change in acoustic impedance at the surface of the fat cells and an increase in scattering of the ultrasound energy by the intramuscular fat.…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of the echo intensity of the median nerve and flexor muscles of the forearm in the young and the elderly

Karmakar²,

Lee³

et al. 2012

BJR

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Objectives: Musculoskeletal structures often appear brighter on imaging in the elderly, which makes it difficult to accurately delineate a peripheral nerve during ultrasound-guided regional anaesthetic procedures. The echo intensity of skeletal muscles is significantly increased in the elderly. However, there are no data comparing the echo intensity of peripheral nerves in the young and the elderly, which this study was designed to evaluate. Methods: 13 healthy, young volunteers (aged ,30 years) and 11 elderly patients (aged .60 years) who were scheduled to undergo orthopaedic lower limb surgery were recruited. The settings of the ultrasound system were standardised and a high-frequency linear array transducer was used for the scan. A transverse scan of the median nerve (MN) and the flexor muscles (FMs) at the left mid-forearm was performed and three video loops of the ultrasound scan were recorded for each subject. Still images were captured from the video loops and normalised. Computer-assisted greyscale analysis was then performed on these images to determine the echo intensity of the MN and the FMs of the forearm. Results: The echo intensity of the MN and FMs of the mid-forearm was significantly increased in the elderly (p,0.005). There was also a reduction in contrast between the MN and the adjoining FM in the elderly (p50.04). Conclusion: Under the conditions of this study, the MN and the FMs in the forearm appeared significantly brighter than those in the young, and there was a loss of contrast between these structures in sonograms of the elderly.

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“…Previous studies have shown that muscle ultrasound can be of value in the diagnosis of neuromuscular disorders by making it possible to reliably assess muscle thickness and objectify muscle atrophy (or hypertrophy) [12,33,36,37]. Besides muscle atrophy changes in muscle morphology can also be visualized with ultrasound.…”

Section: Muscle Ultrasound In Neuromuscular Disordersmentioning

confidence: 99%

“…a muscle becomes whiter in appearance [11,13,36]. It is thought that the replacement of muscle tissue with fat and fibrosis is the main cause of increased muscle echo intensity, as they increase the number of reflections within the muscle and therefore the mean grey value of the muscle in the ultrasound image (Fig 3) [29,35,37]. Markedly increased muscle echo intensity can easily be detected visually (Fig 7).…”

Section: Muscle Ultrasound In Neuromuscular Disordersmentioning

confidence: 99%

Skeletal muscle ultrasound

Pillen

Alfen

2011

Neurological Research

263

220

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Muscle ultrasound is a convenient technique to visualize normal and pathological muscle tissue as it is non-invasive and real-time. Neuromuscular disorders give rise to structural muscle changes that can be visualized with ultrasound: atrophy can be objectified by measuring muscle thickness, while infiltration of fat and fibrous tissue increase muscle echo intensity, i.e. the muscles become whiter on the ultrasound image. Muscle echo intensity need to be quantified to correct for age-related increase in echo intensity and differences between individual muscles. This can be done by gray scale analysis, a method that can be easily applied in daily clinical practice. Using this technique it is possible to detect neuromuscular disorders with predictive values of 90 percent. Only in young children and metabolic myopathies the sensitivity is lower. Ultrasound is a dynamic technique and therefore capable of visualizing normal and pathological muscle movements. Fasciculations can easily be differentiated from other muscle movements. Ultrasound appeared to be even more sensitive in detecting fasciculations compared to EMG and clinical observations, because it can visualize a large muscle area and deeper located muscles. With improving resolution and frame rate it has recently become clear that also smaller scale spontaneous muscle activity such as fibrillations can be detected by ultrasound. This opens the way to a broader use of muscle ultrasound in the diagnosis of peripheral nerve and muscle disorders.

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Skeletal muscle sonography: a correlative study of echogenicity and morphology

Cited by 332 publications

References 3 publications

Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients

Relationship of Quadriceps Muscle Thickness with Motor Paralysis and Muscle Echo Intensity in Post-Stroke Patients

Quantitative evaluation of the echo intensity of the median nerve and flexor muscles of the forearm in the young and the elderly

Skeletal muscle ultrasound

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