Ultrasound Echo Intensity Research Articles

Muscle Ultrasound Echo Intensity and Fiber Type Composition in Young Females.

Ultrasonography has been extensively used to evaluate skeletal muscle morphology. The echo intensity, i.e., the mean pixel intensity of a specific region of interest in an ultrasound image, may vary among muscles and individuals with several intramuscular parameters presumed to influence it. The purpose of this study was to investigate the correlation between muscle echo intensity and muscle fiber type composition in humans. Thirteen female physical education students (age: 22.3 ± 5.4 years, height: 1.63 ± 0.06 m, body mass: 59.9 ± 7.4 kg) with no history of systematic athletic training participated in the study. Body composition with dual X-ray absorptiometry, leg-press maximum strength (1-RM), echo intensity, and the cross-sectional area (CSA) of the vastus lateralis (VL) muscle according to ultrasonography were measured. Muscle biopsies were harvested from the VL site where the echo intensity was measured. VL echo intensity was not significantly correlated with the percentage of type I muscle fibers or with the percentage area of type I muscle fibers. However, when VL echo intensity was corrected for the subcutaneous fat thickness at the site of the measurement, it was significantly correlated with the percentage of type I muscle fibers (r = 0.801, p < 0.01) and the percentage area of type I muscle fibers (r = 0.852, p < 0.01). These results suggest that the echo intensity of the vastus lateralis muscle corrected for the subcutaneous fat thickness at the measurement site may provide an estimate of the muscle fiber type composition, at least in young moderately trained females.

Echo-intensity characterization at implant sites and novel diagnostic ultrasonographic markers for peri-implantitis.

To apply high-frequency ultrasound (HFUS) echo intensity for characterizing peri-implant tissues at healthy and diseased sites and to investigate the possible ultrasonographic markers of health versus disease. Sixty patients presenting 60 implants diagnosed as healthy (N = 30) and peri-implantitis (N = 30) were assessed with HFUS. HFUS scans were imported into a software where first-order greyscale outcomes [i.e., mean echo intensity (EI)] and second-order greyscale outcomes were assessed. Other ultrasonographic outcomes of interest involved the vertical extension of the hypoechoic supracrestal area (HSA), soft-tissue area (STA) and buccal bone dehiscence (BBD), among others. HFUS EI mean values obtained from peri-implant soft tissue at healthy and diseased sites were 122.9 ± 19.7 and 107.9 ± 24.7 grey levels (GL); p = .02, respectively. All the diseased sites showed the appearance of an HSA that was not present in healthy implants (area under the curve = 1). The proportion of HSA/STA was 37.9% ± 14.8%. Regression analysis showed that EI of the peri-implant soft tissue was significantly different between healthy and peri-implantitis sites (odds ratio 0.97 [95% confidence interval: 0.94-0.99], p = .019). HFUS EI characterization of peri-implant tissues shows a significant difference between healthy and diseased sites. HFUS EI and the presence/absence of an HSA may be valid diagnostic ultrasonographic markers to discriminate peri-implant health status.

Quadriceps composition and function influence downhill gait biomechanics >1 year following anterior cruciate ligament reconstruction

BackgroundQuadriceps dysfunction is common following anterior cruciate ligament reconstruction and contributes to aberrant gait biomechanics. Changes in quadriceps composition also occur in these patients including greater concentrations of non-contractile tissue. The purpose of this study was to evaluate associations between quadriceps composition, function, and gait biomechanics in individuals with anterior cruciate ligament reconstruction. MethodsForty-eight volunteers with anterior cruciate ligament reconstruction completed gait biomechanics and quadriceps function and composition assessments. Gait biomechanics were sampled during downhill walking (−10° slope) on an instrumented treadmill. Quadriceps function (peak torque and rate of torque development) was assessed via maximal isometric contractions, while composition was evaluated via ultrasound echo intensity. FindingsGreater quadriceps peak torque was associated with a greater peak knee extension moment (r = 0.365, p = 0.015). Greater vastus lateralis echo intensity (i.e. poorer muscle quality) was associated with less knee flexion displacement (r = −0.316, p = 0.032). Greater echo intensity of the vastus lateralis (r = −0.298, p = 0.044) and rectus femoris (r = −0.322, p = 0.029) was associated with a more abducted knee angle at heel strike. Quadriceps peak torque explained 11–16% of the variance in echo intensity. InterpretationBoth quadriceps function and composition influence aberrant gait biomechanics following anterior cruciate ligament reconstruction. Quadriceps composition appears to provide insight into quadriceps dysfunction independent of muscle strength, as they associated with different gait biomechanics outcomes and shared minimal variance. Future research is necessary to determine the influence of changes in quadriceps composition on joint health outcomes.

Can segmental bioelectrical impedance be used as a measure of muscle quality?

Recent works have shown bioelectrical impedance spectroscopy (BIS) may assess tissue quality. The purpose of this project was to examine associations between ultrasound echo intensity (EI) of quadriceps muscles (vastus lateralis [VL], vastus medialis [VM], vastus intermedius [VI], rectus femoris [RF]) and BIS parameters (R0, R1, C, α, fp), and if the associations are specific to individual muscles or associated with a representation of the entire quadriceps. Twenty-two participants (age: 22 ± 4 years; BMI: 25.47 ± 3.26 kg/m2) participated in all study activities. Participants had transverse ultrasound scans of each individual quadriceps muscle taken at 25, 50, and 75 % of the muscle length to generate an average EI for the VL, VM, VI, and RF, which were further averaged to generate an EI for the entire quadriceps. For BIS, participants were seated with electrodes placed on the thigh to measure the segmental quadriceps. The Cole-impedance model parameters that best fit the BIS data for each participant was used for all analyses. Pearson's correlation coefficient (r) were calculated to determine associations between muscles’ EI and BIS parameters. The results suggest averaged EI of individual VL, VM, VI, RF muscles and the average EI of the segmental quadriceps were significantly related to the R0, C, α metrics of the Cole-impedance model representing quadriceps segmental tissues. This supports that segmental BIS may be an appropriate technique for rapid evaluation of segmental muscle quality.

Uncorrected and subcutaneous fat‐corrected echo intensities are similarly associated with magnetic resonance imaging per cent fat

AbstractBackgroundEstablishing interchangeable biomedical imaging‐based measures to assess myosteatosis clinically may lead to the prevention of muscle wasting, yet neither a consensus measure nor a conversion between measures exists. Ultrasound echo intensity (EI) potentially assesses myosteatosis, but subcutaneous adipose tissue (SAT) thickness and user force application have been shown to influence EI. Although correction factors exist to adjust EI for SAT thickness, they are modelled against poor or no reference measures. Modelling EI corrections against a robust reference measure of myosteatosis, like magnetic resonance imaging (MRI)‐based proton density fat fraction (PDFF), is necessary for EI's clinical application.MethodsHealthy young adults, healthy older adults, and older adults undergoing treatment for lung cancer (n = 10 per group with 50% females) had PDFF and EI at 0, 5, 10, and 15 N measured on their right rectus femoris (RF). We compared EI, SAT thickness, and RF thickness between forces and groups and assessed the relationships between EI adjusted by four different correction factors and PDFF.ResultsThe mean age of our sample was 48.63 ± 19.68 years and had a body mass index of 25.21 ± 5.19 kg/m2. The correlation between PDFF and raw EI was r = 0.59 (P &lt; 0.001) with negligible increases by previously published correction factors (Young: 0.62, P &lt; 0.001; Neto Müller: 0.61, P &lt; 0.001). EI, SAT thickness, and RF thickness did not significantly differ between forces (χ2 = 0.31, P = 0.957; χ2 = 2.39, P = 0.496; and χ2 = 7.75, P = 0.051, respectively). EI and PDFF were significantly lower among young healthy adults compared with older adult groups (χ2 = 12.88, P = 0.002, and χ2 = 9.13, P = 0.010, respectively).ConclusionsEI is correlated with PDFF regardless of force with no improvement from previously published correction factors. Our results suggest that EI is clinically useful and influenced by fat content, yet correction factors must account for more than SAT thickness alone and require further investigation.

MYOGENIC CONTRIBUTORS TO PHYSICAL FUNCTION IN OLDER ADULTS WITH SYMPTOMATIC KNEE OSTEOARTHRITIS

Abstract Knee osteoarthritis (OA) is a leading cause of mobility disability among middle-aged and older adults, and contributes to significant global disease burden. The impact of knee OA on physical function varies widely across individuals, and the factors contributing to this heterogeneity are poorly understood. Recent compelling research suggests that myogenic factors, including muscle quality (MQ), may underly symptoms in knee OA. While MQ is gaining attention in aging research, the role of MQ on functional outcomes in persons with knee OA remains unknown. This pilot study examined morphological and neuromuscular biomarkers of MQ among adults aged 50 years and older (N=44) who met clinical criteria for symptomatic knee OA. Physical performance was assessed using the Short Physical Performance Battery (SPPB). MQ was quantified using B-mode ultrasound (echo intensity) and isokinetic strength measures (force/body mass). Associations between MQ and physical performance were determined, with consideration for clinical pain, age, sex, and body mass index. Pearson correlation analysis indicated SPPB scores were associated with clinical pain, strength, and MQ (r values ranged -.42 – 0.60, p’s&amp;lt; 0.05). Multivariable backward stepwise linear regression analysis demonstrated that MQ biomarkers contributed 39% to variance for SPPB score independent of clinical pain and strength, after adjustment for age, sex, and BMI (b’s = -0.32 – 0.45; p’s &amp;lt; 0.05). MQ is an important consideration for physical function in older adults with chronic knee OA pain, regardless of pain severity, and represents a potentially potent treatment target for disability prevention.

Eight-week neuromuscular electrical stimulation training produces muscle strength gains and hypertrophy, and partial muscle quality improvement in the knee extensors

ABSTRACT This study investigated the effect of an 8-week neuromuscular electrical stimulation (NMES) training programme (3 days/week) on muscle quantity and quality and single-joint performance in the knee extensors. Thirty-nine untrained young male participants were randomly assigned to NMES training (n = 21) and control (n = 18) groups. The 8-week NMES training induced significant increase in the isometric maximal voluntary contraction (MVC) torque of the knee extensors (≈9.3%), muscle volume of the individual and entire quadriceps muscles determined by magnetic resonance imaging (≈3.3%–6.4%), and a significant decrease in the ultrasound echo intensity of the vastus lateralis (≈−4.0%); however, hypertrophy of the vastus intermedius (i.e., the deep muscle) was limited (≈3.3%). In the NMES training group, the repeated measures correlations of the isometric MVC torque with the muscle volume of the entire quadriceps muscle and each quadriceps muscle were significant (r rm (20) = 0.551–0.776), whereas that of the isometric MVC torque with the ultrasound echo intensity of the vastus lateralis was not significant. These findings suggest that NMES training produces muscle strength gains, muscle hypertrophy, and partial muscle quality improvement and that the NMES training-induced muscle strength gains is caused by muscle hypertrophy in the knee extensors.

Rectus Femoris Ultrasound Echo Intensity Is a Valid Estimate of Percent Intramuscular Fat in Patients Following Anterior Cruciate Ligament Reconstruction.

The aim of the work described here was to evaluate quadriceps muscle ultrasound metrics and common demographic variables to create a conversion equation that validly predicts magnetic resonance imaging (MRI) percent intramuscular fat after anterior cruciate ligament reconstruction (ACLR). We recruited 15 participants between the ages of 18 and 35 y who were 1-5 y post-ACLR. For the MRI assessment, we used an iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) sequence to assess the mid-thigh. A single reader manually segmented the rectus femoris on two consecutive MRI slices using ITK-Snap to estimate the percent intramuscular fat. For the ultrasound assessment, a single investigator captured transverse panoramic ultrasound images of the mid-thigh with the participant positioned supine and the knee flexed to 30°. A separate single reader used ImageJ to manually segment the rectus femoris ultrasound images. Ultrasound metrics included muscle cross-sectional area, echo intensity and subcutaneous fat thickness. A stepwise linear multiple regression was used to develop an equation to predict MRI percent intramuscular fat using the ultrasound metrics and common demographics (i.e., age, sex, height, mass). Additionally, intraclass correlation coefficients (ICC2,k) and Bland-Altman plots were used to assess the agreement between true and estimated percent intramuscular fat. Echo intensity and age significantly predicted MRI intramuscular fat percent (p=0.003, r2=0.62). When using the conversion equation, there was high agreement (ICC2,k=0.87, 95% confidence interval: 0.62-0.96) between the estimated and true percent intramuscular fat. Our patient population-specific conversion equation that uses quadriceps muscle ultrasound echo intensity and age is a valid estimate of MRI percent intramuscular fat.

Femoral cartilage ultrasound echo-intensity is a valid measure of cartilage composition.

This study aimed to create a conversion equation that accurately predicts cartilage magnetic resonance imaging (MRI) T2 relaxation times using ultrasound echo-intensity and common participant demographics. We recruited 15 participants with a primary anterior cruciate ligament reconstruction between the ages of 18 and 35 years at 1-5 years after surgery. A single investigator completed a transverse suprapatellar scan with the ACLR limb in max knee flexion to image the femoral trochlea cartilage. A single reader manually segmented the femoral cartilage cross-sectional area to assess the echo-intensity (i.e., mean gray-scale pixel value). At a separate visit, a T2 mapping sequence with the MRI beam set to an oblique angle was used to image the femoral trochlea cartilage. A single reader manually segmented the cartilage cross-sectional area on a single MRI slice to assess the T2 relaxation time. A stepwise, multiple linear regression was used to predict T2 relaxation time from cartilage echo-intensity and common demographic variables. We created a conversion equation using the regression betas and then used an ICC and Bland-Altman plot to assess agreement between the estimated and true T2 relaxation time. Cartilage ultrasound echo-intensity and age significantly predicted T2 relaxation time (F = 7.33, p = 0.008, R2 = 0.55). When using the new conversion equation to estimate T2 relaxation time from cartilage echo-intensity and age, there was strong agreement between the estimated and true T2 relaxation time (ICC2,k = 0.84). This study provides promising preliminary data that cartilage echo-intensity combined with age can be used as a clinically accessible tool for evaluating cartilage composition.

Investigating the Association Between Muscular Ultrasonographic Alterations and Clinical Symptoms in Patients With Inflammatory Myopathy.

Muscle biopsy is commonly used to diagnose inflammatory myopathies. We evaluated the ability of muscle ultrasound, a non-invasive and simple tool, to distinguish between healthy subjects and patients with inflammatory myopathy. This study was conducted on 17 patients recently diagnosed with biopsy inflammatory myopathies (12 dermatomyositis, 5 polymyositis) compared with 17 age- and gender-matched healthy control adults. All patients underwent clinical assessments, including manual muscle testing, hand-held dynamometry, and muscle ultrasound evaluations, including thickness and echo intensity in predefined muscle groups. The disease duration was seven months (interquartile range: 3 to 11 months). Except for the biceps and gastrocnemius, patients' muscles had significantly higher echo intensity and lower thickness than the control group. The echo intensity sum-score manifested the highest area under the curve compared to the sum-scores of other variables (echo intensity vs manual muscle testing: Area under curves-difference=0.18, P<0.01; echo intensity vs dynamometry: Area under curves-difference=0.14, P=0.02; echo intensity vs thickness: Area under curves-differences-difference=0.25, P<0.01). The echo intensity of muscles differed significantly between healthy individuals and patients with inflammatory myopathies and may serve as a useful diagnostic biomarker.

Sarcopenia, More Than Just Muscle Atrophy: Imaging Methods for the Assessment of Muscle Quantity and Quality.

Sarcopenia, a progressive reduction of muscle mass and function, is associated with adverse outcomes in the elderly. Sarcopenia and muscle atrophy are not equal processes. Low muscle strength in association with muscle quantity/quality reduction is currently the optimal method for assessing sarcopenia. There is a practical need for indirect measurement of muscle strength using state-of-the-art imaging techniques. The following provides a narrative, broad review of all current imaging techniques for evaluating muscles and identifying sarcopenia, including DEXA, CT, MRI, and high-resolution ultrasound, their main strengths, weaknesses, and possible solutions to problems regarding each technique. Well-recognized imaging methods for the assessment of muscle mass are explained, including evaluation with DEXA, CT, and MRI muscle quantity assessment, ultrasound evaluation of muscle thickness and CSA, and their correlations with established muscle mass calculation methods. A special focus is on imaging methods for muscle quality evaluation. Several innovative and promising techniques that are still in the research phase but show potential in the assessment of different properties of muscle quality, including MRI DIXON sequences, MRI spectroscopy, Diffusion Tensor Imaging, ultrasound echo intensity, ultrasound elastography, and speed-of-sound ultrasound imaging are briefly mentioned. · Sarcopenia definition includes low muscle strength and low muscle quantity/quality.. · DEXA is a low-radiation method for whole-body composition measurement in a single image.. · CT has established cut-off values for muscle quality/quantity evaluation and sarcopenia diagnosis.. · MRI is the most sophisticated muscle quality assessment method capable of evaluating myosteatosis, myofibrosis, and microstructure.. · Ultrasound can evaluate muscle quality, including tissue architecture, and elasticity with excellent spatial resolution.. · Vasilevska Nikodinovska V, Ivanoski S, . Sarcopenia, More Than Just Muscle Atrophy: Imaging Methods for the Assessment of Muscle Quantity and Quality. Fortschr Röntgenstr 2023; 195: 777 - 789.

Muscle Ultrasound in an Open-Label Study of Losmapimod in Subjects with FSHD1 (P5-8.011)

<h3>Objective:</h3> Evaluate muscle ultrasound (US) in an open-label trial of losmapimod in FSHD1 patients. <h3>Background:</h3> Natural history studies have identified US as a viable imaging biomarker for FSHD muscle progression, complementary to MRI. Losmapimod is an orally active, selective, small molecule inhibitor of p38α/β. <h3>Design/Methods:</h3> Fourteen subjects ages 18 to 65 years with genetically confirmed FSHD1, clinical severity score 2 to 4 (range 0–5) and MRI-eligible skeletal muscles for needle biopsy received open-label 15 mg twice daily losmapimod for 52 weeks with the primary objective of safety. Assessments included safety, MRI, US, clinical outcomes, and Patient Reported Outcomes. US was performed on 7 muscles bilaterally using a standardized protocol. US echointensity was expressed as a z-score relative to matched healthy controls, with abnormal being defined as &gt;2. <h3>Results:</h3> The mean (SD) change from baseline in echogenicity of all muscles was −0.17 (0.9), in the upper extremity muscles −0.32 (0.9) and lower extremities −0.13 (1.0), represented a trend towards improvement. The distribution of muscle z-scores (&lt;2, 2–4, 4–6, and &gt;6) at baseline and after 52 weeks of treatment remained the same. Echointensity correlated strongly with MFI for the biceps brachii (r=0.84, p&lt;0.01), tibialis anterior (r=0.76, p&lt;0.01), and gastrocnemius medialis (r=0.50, p&lt;0.01). Correlations between US and clinical outcomes will be presented. <h3>Conclusions:</h3> Losmapimod demonstrated stability in muscle US over 52 weeks. <b>Disclosure:</b> The institution of Mr. Kools has received research support from Fulcrum Therapeutics. The institution of Mrs. Voermans has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dynacure. The institution of Mrs. Voermans has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. The institution of Mrs. Voermans has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neuromuscular disorder. The institution of Karlien Mul has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avidity Biosciences. Dr. Jiang has received personal compensation for serving as an employee of Fulcrum Therapeutics. Dr. Shoskes has received personal compensation for serving as an employee of Fulcrum Therapeutics. An immediate family member of Dr. Shoskes has received personal compensation for serving as an employee of Exact Science. Ms. Marshall has nothing to disclose. Dr. Karlsson has received personal compensation for serving as an employee of AMRA Medical.

Comparison of multifidus muscle intramuscular fat by ultrasound echo intensity and fat-water based MR images in individuals with chronic low back pain

PurposeThe aim of this observational cross-sectional study was to examine correlations of intramuscular fat content in lumbar multifidus (LM) by comparing muscle echo intensity (EI) and percent fat signal fraction (%FSF) generated from ultrasound (US) and magnetic resonance (MR) images, respectively. MethodsMRI and US images from 25 participants (16 females, 9 males) selected from a cohort of patients with chronic low back pain (CLBP) were used. Images were acquired bilaterally, at the L4 and L5 levels (e.g., 4 sites). EI measurements were acquired by manually tracing the cross-sectional border of LM. Mean EI of three US images per site were analyzed (e.g., raw EI). A correction factor for subcutaneous fat thickness (SFT) was also calculated and applied (e.g., corrected EI). Corresponding fat and water MR images were used to acquire %FSF measurements. Intra-rater reliability was assessed by intraclass coefficients (ICC). Pearson correlations and simple linear regression were used to assess the relationship between %FSF, raw EI and corrected EI measurements. ResultsThe intra-rater ICCs for all measurements were moderate to excellent. Correlations between %FSF vs. raw EI and corrected EI were moderate to strong (0.40 < r < 0.52) and (0.40 < r < 0.51), respectively. Moderate correlations between SFT and EI were also identified. ConclusionUS is a low-cost, non-invasive, accessible, and reliable method to examine muscle composition, and presents a promising solution for assessing and monitoring the effect of different treatment options for CLBP in clinical settings.

Interframe Echo Intensity Variation of Subregions and Whole Plaque in Two-Dimensional Carotid Ultrasonography: Simulations and In Vivo Observations.

The risk of cardiovascular disease is associated with the echo intensity of carotid plaques in ultrasound images and their cardiac cycle-induced intensity variations. In this study, we aimed to 1) explore the underlying origin of echo intensity variations by using simulations and 2) evaluate the association between the two-dimensional (2D) spatial distribution of these echo intensity variations and plaque vulnerability. First, we analyzed how out-of-plane motion and compression of simulated scattering spheres of different sizes affect the ultrasound echo intensity. Next, we propose a method to analyze the features of the 2D spatial distribution of interframe plaque echo intensity in carotid ultrasound image sequences and explore their associations with plaque vulnerability in experimental data. The simulations showed that the magnitude of echo intensity changes was similar for both the out-of-plane motion and compression, but for scattering objects smaller than 1 mm radius, the out-of-plane motion dominated. In experimental data, maps of the 2D spatial distribution of the echo intensity variations had a low correlation with standard B-mode echo intensity distribution, indicating complementary information on plaque tissue composition. In addition, we found the existence of ∼1 mm diameter subregions with pronounced echo intensity variations associated with plaque vulnerability. The results indicate that out-of-plane motion contributes to intra-plaque regions of high echo intensity variation. The 2D echo intensity variation maps may provide complementary information for assessing plaque composition and vulnerability. Further studies are needed to verify this method's role in identifying vulnerable plaques and predicting cardiovascular disease risk.

P.144a Muscle ultrasound in an open-label study of losmapimod in subjects with FSHD1

Evaluate muscle ultrasound (US) in an open-label trial of losmapimod in FSHD1 patients. Natural history studies have identified US as a viable imaging biomarker for FSHD muscle progression, complementary to MRI. Losmapimod is an orally active, selective, small molecule inhibitor of p38α/β. Fourteen subjects ages 18 to 65 years with genetically confirmed FSHD1, clinical severity score 2 to 4 (range 0-5) and MRI-eligible skeletal muscles for needle biopsy received open-label 15 mg twice daily losmapimod for 52 weeks with the primary objective of safety. Assessments included safety, MRI, US, clinical outcomes, and patient reported outcomes. US was performed on 7 muscles bilaterally using a standardized protocol. US echointensity was expressed as a z-score relative to matched healthy controls, with abnormal being defined as >2. The mean (SD) change from baseline in echogenicity of all muscles was -0.17 (0.9), in the upper extremity muscles -0.32 (0.9) and lower extremities -0.13 (1.0), represented a trend towards improvement1. The distribution of muscle z-scores (<2, 2-4, 4-6, and >6) at baseline and after 52 weeks of treatment remained the same. Echointensity correlated strongly with MFI for the biceps brachii (r=0.84, p<0.01), tibialis anterior (r=0.76, p<0.01), and gastrocnemius medialis (r=0.50, p<0.01). Correlations between US and clinical outcomes will be presented. Losmapimod demonstrated stability in muscle US over 52 weeks.

Enhanced echo intensity of skeletal muscle is associated with poor physical function in hemodialysis patients: a cross-sectional study

BackgroundPatients on hemodialysis often suffer from reduced muscle strength and exercise capacity due to the decreased quantity and quality of muscle. Cumulative studies showed ultrasound echo intensity (EI) had great potential in evaluating muscle quality. The objective of this study was to evaluate the relationship between EI of skeletal muscle and physical function of patients on maintenance hemodialysis.MethodsCross-sectional area (CSA) and mean EI of the right rectus femoris were measured by ultrasound to evaluate the quantity and quality of the muscle, respectively. Physical function was measured by handgrip strength (HGS), gait speed, sit-to-stand 60 s (STS-60) test, and instrumental activities of daily living (IADL) scale.ResultsA total of 107 patients on hemodialysis were included, with women accounting for 37.3% (n = 40), and a mean age of 53.53 ± 12.52 years. Among the patients on hemodialysis, EI was moderately and negatively correlated with HGS (r = − 0.467, P < 0.001), gait speed (r = − 0.285, P = 0.003), and STS-60 (r = − 0.313, P = 0.001). Multiple regression analyses adjusted for CSA showed that the enhanced EI of patients on hemodialysis remained associated with worse HGS (β = − 0.207, P = 0.047), lower gait speed (β = − 0.002, P = 0.001), less STS-60 (β = − 0.136, P = 0.049), and a higher likelihood of dependency in IADL (Odds Ratio: 1.070, 95% CI: [1.033–1.111], P = 0.001).ConclusionsIn patients on hemodialysis, enhanced EI in the skeletal muscle measured via ultrasound was correlated with poor physical performance. The combined muscle quality and muscle quantity evaluation provide more information for assessing the level of physical function of the patients.

Ultrasound and MR muscle imaging in new onset idiopathic inflammatory myopathies at diagnosis and after treatment: a comparative pilot study.

To prospectively compare ultrasound (US) and whole-body MRI for detection of muscle abnormalities compatible with idiopathic inflammatory myopathies (IIM). Newly diagnosed IIM patients underwent US (14 muscles) and MRI (36 muscles) at diagnosis and after nine weeks monotherapy with intravenous immunoglobulin. Muscles were compatible with IIM when quantitative US echo-intensity (EI) z scores was ≥1.5, semi-quantitative US Heckmatt score was ≥2, qualitative US was abnormal, or when MRI showed oedema on T2-weighted images. At patient level, findings were classified as abnormal when quantitative US EI z scores was >1.5 (n = 3 muscles), >2.5 (n = 2 muscles) or >3.5 (n = 1 muscle), or if ≥3 muscles showed abnormalities as described above for the other diagnostic methods. At diagnosis, in 18 patients US of 252 muscles revealed abnormalities in 36 muscles (14%) with quantitative, in 153 (61%) with semi-quantitative and in 168 (67%) with qualitative analysis. MRI showed oedema in 476 out of 623 muscles (76%). Five patients (28%) reached abnormal classification with quantitative US, 16 (89%) with semi-quantitative and qualitative US, and all patients (100%) with MRI. Nine-week follow-up of 12 patients showed no change over time with quantitative US or MRI, and a decrease in abnormalities with semi-quantitative US (P<0.01), and qualitative US (P<0.01). At diagnosis, MRI was more sensitive than US to detect muscle abnormalities compatible with IIM. Semi-quantitative US and qualitative US detected abnormalities in the majority of the patients while evaluating fewer muscles than MRI and showed change over time after nine weeks of treatment.

Muscle Contractures in Adults With Cerebral Palsy Characterized by Combined Ultrasound-Derived Echo Intensity and Handheld Dynamometry Measures.

We used ultrasound-derived echo intensity and hand-held dynamometry to characterize plantar flexor muscle contractures in adults with cerebral palsy (CP). Eleven adults with CP (aged 41 ± 12 y, Gross Motor Function Classification System I-II) and 11 neurologically intact adults (aged 35 ± 10 y) participated in the study. Echo intensity was measured from the medial gastrocnemius muscle using brightness mode ultrasound. Hand-held dynamometry was used to quantify plantar flexor passive muscle stiffness and ankle joint passive range of motion (pROM). Echo intensity correlated with both passive muscle stiffness (r=0.57, p=0.006) and pROM (r=-0.56, p=0.006). Ultrasound echo intensity (p=0.02, standardized mean difference [SMD]=1.13) and passive muscle stiffness (p < 0.001, SMD=1.99) were higher and ankle joint pROM (p < 0.001, SMD=2.69) was lower in adults with CP than in neurologically intact adults. We conclude that combined ultrasound-derived echo intensity and hand-held dynamometry may be used to provide an objective characterization of muscle contractures.

POS-565 Enhanced Echo Intensity of Skeletal Muscle is Associated with Poor Physical Function in Male Hemodialysis Patients

To evaluate the relationship between ultrasound echo intensity (EI) of skeletal muscle and physical function of patients on maintenance hemodialysis.To evaluate the relationship between ultrasound echo intensity (EI) of skeletal muscle and physical function of patients on maintenance hemodialysis.

亜急性期脳卒中患者における大腿部骨格筋の筋厚，筋輝度と関連要因の検討

亜急性期脳卒中患者における大腿部骨格筋の筋厚，筋輝度と関連要因の検討