Abstract
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, age-related 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 2nd trimester up to the end of the 3rd 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.
Highlights
Muscle ultrasound provides a non-invasive and applicable tool for the detection of muscle alterations in children and adults suspected of neuromuscular pathology [1,2,3,4,5]
In healthy children older than two years of age, it has been reported that muscle ultrasound density (MUD) values may generally remain stable [15], there might be some exceptions in individual muscles [20]
In healthy fetuses and infants under one year of age, we aimed to explore the temporal relationship between MUD trends and gestational age
Summary
Muscle ultrasound provides a non-invasive and applicable tool for the detection of muscle alterations in children and adults suspected of neuromuscular pathology [1,2,3,4,5]. Muscle ultrasound density in healthy fetuses and infants fetuses and young children, this non-invasive surveillance technique has the advantage above other more invasive approaches, such as anesthesia requiring MRI and/or muscle biopsy performances [3,16]. In fetuses and infants younger than one year of age, healthy control values and potential age related trends are still lacking. In healthy fetuses and infants under one year of age, we aimed to explore the temporal relationship between MUD trends and gestational age. Developmental insight in perinatal MUD control values could contribute to the understanding of physiologic muscle maturation, could enable cross-sectional comparison between innovative fetal treatment strategies (such as in fetal open and endoscopic closure of the neural tube defect) and enable non-invasive, longitudinal surveillance of perinatal neuro-muscular abnormalities
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