Cross-sectional Area Values Research Articles

Elastography of nerves in the wrists of cyclists.

This study aimed to investigate changes in the elasticity of the median and ulnar nerves in cyclists. The study included 30 cyclists and 2 non-biking reference groups that included 32 healthy volunteers and 32 individuals with ulnar nerve entrapment neuropathies. All participants underwent physical, ultrasonographic, and elastographic examinations including assessment of nerve cross-sectional area (CSA) and stiffness (SWE). The cyclists' group was tested before and after a 2-hour workout. The values of ulnar nerve CSA and stiffness in Guyon's canal in resting cyclists were 5.30 ± 1.51 mm2 and 49.05 ± 11.18 kPa, respectively. These values were significantly higher than in the healthy volunteers, but not higher than in the nerve entrapment group. Median nerve CSA and stiffness at rest were 9.10 ± 2.61 mm2 and 38.54 ± 14.87 kPa, respectively. Both values were higher than respective values in the healthy group. Cycling induced an increase in all these parameters, although the increase in nerve stiffness was more noticeable than in CSA. The elasticity of the median and ulnar nerve in cyclists remains within normal limits, questioning the belief that cyclists are at risk of nerve palsy in Guyon's canal. However, cycling workout does exert compression, resulting in transient oedema of both nerves. The dynamics of changes was more noticeable in SWE examination than in conventional ultrasound, which may depend on SWE sensitivity.

Wallerian Degeneration Assessed by Multi-Modal Magnetic Resonance Imaging of Cervical Spinal Cord Is Associated With Neurological Impairment After Spinal Cord Injury.

While Wallerian degeneration (WD) is a crucial pathological process induced with spinal cord injury (SCI), its underlying mechanisms is still understudied. In this study, we aim to assess structural alterations and clinical significance of WD in the cervical cord following SCI using multi-modal magnetic resonance imaging (MRI), which combines T2*-weighted imaging and diffusion tensor imaging (DTI). T2*-weighted images allow segmentation of anatomical structures and the detection of WD on macrostructural level. DTI, on the other hand, can identify the reduction in neuroaxonal integrity by measuring the diffusion of water molecules on the microstructural level. In this prospective study, 35 SCI patients (19 paraplegic and 16 tetraplegic patients) and 12 healthy controls were recruited between July 2020 and May 2022. The hyperintensity voxels in the dorsal column was manually labeled as WD on T2*-weighted images. The mean cross-sectional area (CSA) and mean DTI indexes of WD at the C2 level were calculated and compared between groups. Correlation analysis was used to determine the associations of the magnitude of WD with lesion characteristics and clinical outcomes. Compared with controls, SCI patients showed evident hyperintensity (35/35) and decreased neuroaxonal integrity (p < 0.05) within the dorsal column at the C2 level. A higher neurological level of injury was associated with a larger mean CSA and reduction in neuroaxonal integrity within WD (p < 0.05). Smaller total and dorsal tissue bridges were related to greater mean CSA and lower fractional anisotropy values in WD (p < 0.05), respectively. Moreover, SCI participants with significantly larger CSAs and significantly lower microstructural integrity had worse sensory outcomes (p < 0.05). This comprehensive evaluation of WD can help us better understand the mechanisms of WD, monitor progression, and assess the effectiveness of therapeutic interventions after SCI.

Cutoff value of the geniohyoid muscle mass to identify sarcopenic dysphagia by ultrasonography.

Determining the strength and area of the swallowing muscles is important in patients with sarcopenic dysphagia. Although the normative data on the strength of the swallowing muscles have been reported, those of the area of the geniohyoid muscle are poorly investigated. We investigated the cross-sectional area of the geniohyoid muscle in Japanese subjects without dysphagia using ultrasonography to determine the normative and cut-off values. 142 subjects without dysphagia were included. The older group (age ≥ 65years) included 36 (women 27/men 9) subjects, and the younger group (age ≤ 39years) included 106 (women 54/men 52) subjects. The cross-sectional area of the geniohyoid muscle was measured by ultrasound. The mean of the younger group-2 standard deviation (SD) was calculated and used as a cut-off value for low swallowing muscle mass. The mean (SD) of the area of the geniohyoid muscle of each group was as follows: older women group 167.2 (32.6) mm2, older men group 193.2 (49.5) mm2, younger women group 247.3 (37.4) mm2, younger men group 313.1 (59.2) mm2. The mean 2SD of the geniohyoid muscle area in the younger women group was 172.5mm2 and in the younger men group 194.7mm2. We found that the cut-off value of the ultrasonographic cross-sectional area of the geniohyoid muscle was 172.5mm2 for women and 194.7mm2 for men. These values could be used as cut-off values for the mass of the geniohyoid muscle to identify patients with sarcopenic dysphagia.

Gastric Volume and Antral Area in the Fasting State: A Meta-analysis of Individual Patient Data.

Pulmonary aspiration of gastric content is a serious anesthetic complication. Gastric point-of-care ultrasound can determine the type and volume of gastric content when clinical information is equivocal. However, a cutoff value of either antral cross-sectional area or volume that may be considered as the upper limit of normal in fasting subjects is still controversial. The aim of this study is to characterize the distribution of baseline antral area and volume in fasting adult subjects and to identify an upper limit (95th percentile) of these distributions. The authors conducted a meta-analysis of individual participant data of primary studies from an academic research network of investigators collaborating in gastric ultrasound. Studies between January 2009 and December 2020 were included. Twelve primary studies met inclusion criteria and were included in the analysis with a sample size of 1,203 subjects. The 95th percentile of area values (measured in the right lateral decubitus) was 9.9 cm2 (95% CI, 9.4 to 10.4), and of volume, 2.3 ml/kg (95% CI, 2.3 to 2.4). In addition, an antrum grade 0 or 1 indicates a 98% probability of an antral area below the 95th percentile. An area of 10 cm2 measured in the right lateral decubitus could be a simple, data-driven upper limit of antral area that could serve as a surrogate of upper limit of normal gastric volume values in fasting adults. These results are limited by the highly selected sampling of the studies included.

Acute muscle loss assessed using panoramic ultrasound in critically ill adults: a prospective observational study.

Panoramic ultrasound is one of the recently introduced ultrasound evaluation techniques. We herein examined the relationship between the cross-sectional area of the rectus femoris muscle on panoramic ultrasound and its volume based on the gold standard computed tomography (CT) evaluation. This was a single-center prospective observational study. A panoramic ultrasound assessment of the cross-sectional area of the rectus femoris muscle and a simple CT evaluation of its volume were performed on days 1 and 7 of hospitalization. Physical functions were assessed at discharge. Twenty patients were examined. The rate of change in the cross-sectional area of the rectus femoris muscle on panoramic ultrasound correlated with that in its volume on CT (correlation coefficient 0.59, p = 0.0061). In addition, a correlation was observed between the absolute value for the rectus femoris muscle cross-sectional area on panoramic ultrasound and physical functions at discharge. Rectus femoris muscle distances did not correlate with either. In the acute phase of critical illness, the cross-sectional area of the rectus femoris muscle on panoramic images correlated with its volume on CT and, thus, it is a valid method for assessing muscle mass.

Determining Optimal Cut-Off Value For Ultrasound-Measured Median Nerve Cross-Sectional Area For Diagnosis Of Carpal Tunnel Syndrome In A Sample Of Egyptian Population

Determining Optimal Cut-Off Value For Ultrasound-Measured Median Nerve Cross-Sectional Area For Diagnosis Of Carpal Tunnel Syndrome In A Sample Of Egyptian Population

On the behaviour of impinging sweeping jets: effects of the mixing chamber length, the feedback channel minimum cross-sectional area and the nozzle-to-plate distance

An experimental investigation on the effects of the mixing chamber length, the feedback channel minimum cross-sectional area and the nozzle-to-plate distance on the external flow field of impinging sweeping jets is performed by employing the Particle Image Velocimetry (PIV) technique. Three sweeping jet devices, characterized by different mixing chamber lengths (Lf/w=4.5,3.5,2.5, being w the width of the exit nozzle throat section), are investigated. Furthermore, in order to analyse different minimum cross-sectional area values, the geometry of the feedback channels of the device characterized by the longest mixing chamber length is varied. In particular, five different values of g/w (1, 0.67, 0.50, 0.33, and 0.17) are taken into account, being g the minimum passage width of the feedback channels. Time-averaged and phase-averaged measurements are carried out for non-dimensional nozzle-to-plate distances H/w ranging between 2 and 10, with a spacing of 2. As for the effects of the mixing chamber length, the devices characterized by Lf/w<4.5 do not generate an oscillating jet, thus the time-averaged flow field exhibits a single jet structure, while a twin-jet pattern is found for the device having Lf/w=4.5, due to the oscillating motion of the jet. Furthermore, due to the absence of the jet oscillation, the values assumed by the phase-correlated kinetic energy (PKE) are significantly lower for the devices having Lf/w<4.5. Moreover, for the latter devices, the highest values of the turbulent kinetic energy (TKE) are reached in the jet shear layers, which are aligned to the streamwise direction, instead, for the device having Lf/w=4.5, the TKE assumes higher values in proximity of the jet centreline. As for the effects of the feedback channel minimum cross-sectional area, the decrease of g/w determines an increase of the oscillation frequency and a reduction of the jet oscillation amplitude, with a subsequent strong decrease of the PKE and an increase of the TKE values in proximity of the jet centreline. As regards the effects of the nozzle-to-plate distance, by increasing this parameter for the device having Lf/w=4.5 the jet no longer sweeps in a rigid-like way between the two most deflected positions in the external flow field and the PKE values in the stagnation regions decrease.

Comparing coronary artery cross-sectional area among asymptomatic South Asian, White, and Black participants: the MASALA and CARDIA studies

BackgroundSouth Asian individuals have high risk of atherosclerotic cardiovascular disease (ASCVD). Some investigators suggest smaller coronary artery size may be partially responsible.MethodsWe compared the left anterior descending (LAD) artery cross-sectional area (CSA) (lumen and arterial wall) among South Asians in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study with White and Black participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study, adjusting for BMI, height, and other ASCVD risk factors. We used thin-slice non-contrast cardiac computed tomography to measure LAD CSA. We used linear regression models to determine whether race/ethnicity was associated with LAD CSA after adjusting for demographic factors, BMI, height, coronary artery calcium (CAC), and traditional cardiovascular risk factors.ResultsOur sample included 3,353 participants: 513 self-identified as South Asian (44.4% women), 1286 as Black (59.6% women), and 1554 as White (53.5% women). After adjusting for age, BMI, height, there was no difference in LAD CSA between South Asian men and women compared to White men and women, respectively. After full adjustment for CVD risk factors, LAD CSA values were: South Asian women (19.9 mm2, 95% CI [18.8 – 20.9]) and men (22.3 mm2, 95% CI [21.4 – 23.2]; White women (20.0 mm2, 95% CI [19.4—20.5]) and men (23.6 mm2, 95% CI [23.0—24.2]); and Black women (21.6 mm2, 95% CI [21.0 – 22.2]) and men (26.0 mm2, 95% CI [25.3 – 26.7]). Height, BMI, hypertension, CAC, and age were positively associated with LAD CSA; current and former cigarette use were inversely associated.ConclusionsSouth Asian men and women have similar LAD CSA to White men and women, and smaller LAD CSA compared to Black men and women, respectively, after accounting for differences in body size. Future studies should determine whether LAD CSA is associated with future ASCVD events.

Effects of Resistance Training Overload Progression Protocols on Strength and Muscle Mass.

The aim of this study was to compare the effects of progressive overload in resistance training on muscle strength and cross-sectional area (CSA) by specifically comparing the impact of increasing load (LOADprog) versus an increase in repetitions (REPSprog). We used a within-subject experimental design in which 39 previously untrained young persons (20 men and 19 women) had their legs randomized to LOADprog and REPSprog. Outcomes were assessed before and after 10 weeks of training. Muscle strength was assessed using the one repetition maximum (1RM) test on the leg extension exercise, and the CSA of the vastus lateralis was assessed by ultrasonography. Both protocols increased 1RM values from pre (LOADprog: 52.90±16.32 kg; REPSprog: 51.67±15.84 kg) to post (LOADprog: 69.05±18.55 kg, REPSprog: 66.82±17.95 kg), with no difference between them (P+>+0.05). Similarly, both protocols also increased in CSA values from pre (LOADprog: 21.34±4.71 cm²; REPSprog: 21.08±4.62 cm²) to post (LOADprog: 23.53±5.41 cm², REPSprog: 23.39±5.19 cm²), with no difference between them (P+>+0.05). In conclusion, our findings indicate that the progression of overload through load or repetitions can be used to promote gains in strength and muscle hypertrophy in young men and women in the early stages of training.

Ultrasonographic evaluation of ulnar nerve morphology in patients with ulnar nerve instability.

Ulnar nerve instability (UNI) in the retroepicondylar groove is described as nerve subluxation or dislocation. In this study, considering that instability may cause chronic ulnar nerve damage by increasing the friction risk, we aimed to examine the effects of UNI on nerve morphology ultrasonographically. Asymptomatic patients with clinical suspicion of UNI were referred for further clinical and ultrasonographic examination. Based on ulnar nerve mobility on ultrasound, the patients were first divided into two groups: stable and unstable. The unstable group was further divided into two subgroups: subluxation and dislocation. The cross-sectional area (CSA) of the nerve was measured in three regions relative to the medial epicondyle (ME). In the ultrasonographic evaluation, UNI was identified in 59.1% (52) of the 88 elbows. UNI was bilateral in 50% (22) of the 44 patients. Mean CSA was not significantly different between groups. A statistically significant difference in ulnar nerve mobility was found between the group with CSA of <10 versus ≥10 mm2 (p = .027). Nerve instability was found in 85.7% of elbows with an ulnar nerve CSA value of ≥10 mm2 at the ME level. The probability of developing neuropathy in patients with UNI may be higher than in those with normal nerve mobility. Further prospective studies are required to elucidate whether asymptomatic individuals with UNI and increased CSA may be at risk for developing symptomatic ulnar neuropathy at the elbow.

One-leg standing time is a simple measure for loss of skeletal muscle mass and fat deposition in muscle: the J-SHIPP study

BackgroundsOne-leg standing time (OLST) has been frequently used physical performance measure; however, what muscular characteristics OLST represents remains uncertain.AimThis cross-sectional study aimed to investigate the association between OLST and muscle characteristics to clarify the possibility of using OLST as a physical performance measure.MethodsStudy participants comprised 1144 older adults aged 65 years or older. Computed tomography images provided mid-thigh skeletal muscle cross-sectional area and mean attenuation value. OLST was measured for a maximum of 60 s. Static postural instability was assessed using a posturography.ResultsA frequency of OLST < 20 s was increased by quartiles of muscle cross-sectional area (Q1: 33.6, Q2: 12.8, Q3: 13.6, Q4: 11.9%, P < 0.001) and mean attenuation value (Q1: 32.3, Q2: 21.7, Q3: 14.3, Q4: 7.7%, P < 0.001). Results of the multinomial regression analysis indicated that muscle cross-sectional area and mean attenuation value were independently associated with an OLST of less than 20 s. The crude odds ratio of OLST less than 20 s for the lowest quartiles of both cross-sectional area and mean attenuation value was 4.19 (95% CI: 3.01 − 5.84). The cross-sectional area of muscles with greater fat deposition was inversely associated with OLST, while that with smaller fat deposition showed a positive association with OLST, indicating why mean attenuation value and cross-sectional area were independently associated with OLST. No clear relationship was observed with static postural instability.ConclusionOLST was a simply measurable quantifiable physical measure representing the loss of muscle mass and quality in older adults.

Biometry extraction and probabilistic anatomical atlas of the anterior Visual Pathway using dedicated high-resolution 3-D MRI

Anterior Visual Pathway (aVP) damage may be linked to diverse inflammatory, degenerative and/or vascular conditions. Currently however, a standardized methodological framework for extracting MRI biomarkers of the aVP is not available. We used high-resolution, 3-D MRI data to generate a probabilistic anatomical atlas of the normal aVP and its intraorbital (iOrb), intracanalicular (iCan), intracranial (iCran), optic chiasm (OC), and tract (OT) subdivisions. We acquired 0.6 mm3 steady-state free-precession images from 24 healthy participants using a 3 T scanner. aVP masks were obtained by manual segmentation of each aVP subdivision. Mask straightening and normalization with cross-sectional area (CSA) preservation were obtained using scripts developed in-house. A probabilistic atlas (“aVP-24”) was generated by averaging left and right sides of all subjects. Leave-one-out cross-validation with respect to interindividual variability was performed employing the Dice Similarity Index (DSI). Spatially normalized representations of the aVP subdivisions were generated. Overlapping CSA values before and after normalization demonstrate preservation of the aVP cross-section. Volume, length, CSA, and ellipticity index (ε) biometrics were extracted. The aVP-24 morphology followed previous descriptions from the gross anatomy. Atlas spatial validation DSI scores of 0.85 in 50% and 0.77 in 95% of participants indicated good generalizability across the subjects. The proposed MRI standardization framework allows for previously unavailable, geometrically unbiased biometric data of the entire aVP and provides the base for future spatial-resolved, group-level investigations.

The Effect of Oral Fluid Administration 1 Hour before Surgery on Preoperative Anxiety and Gastric Volume in Pediatric Patients.

Today, preoperative fasting guidelines have changed, allowing clear liquid intake up to 1 h before surgery. However, concerns remain regarding the risk of aspiration associated with clear liquid intake. This study aimed to investigate the impact of clear fluid given 1 h before surgery on child anxiety and gastric volumes. A prospective, randomized, controlled study included 90 patients aged 5-12 years. The patients were randomly allocated into three groups by a computer-generated randomization: group F (n = 30): standard fasting group, group W (n = 30): patients who received oral water at a dose of 5 mL/kg 1 h before surgery, group C (n = 30): patients who received oral carbohydrate fluid at a dose of 5 mL/kg 1 h before surgery. All patients were assessed using the modified Yale Preoperative Anxiety Scale (m-YPAS) before and 1 h after fluid administration. Antral cross-sectional area (CSA) was measured with ultrasonography after intubation, and gastric residual volume (GRV) was calculated. Hemodynamic data, blood sugar level, and parental satisfaction were also recorded. The m-YPAS scores obtained after 1 h were significantly lower in group C than in the other groups (p &lt; 0.001). Antral CSA and GRV values were lower in group C and group W than in the fasting group (p &lt; 0.001). Parental satisfaction was highest in group C. This study suggests that allowing a carbohydrate-rich clear liquid intake 1 h before surgery can significantly reduce preoperative anxiety in pediatric patients without increasing the risk of aspiration.

Multimodal ultrasound evaluation of asymptomatic ulnar nerve dislocation at the cubital tunnel.

Ultrasonography has received broad acceptance as an effective peripheral nervous imaging examination. Shear wave elastography (SWE) can quantitatively assess the stiffness of nerves; however, little research has been conducted on elastography for ulnar nerve dislocation. The purpose of this study was thus to investigate the characteristics of multimodal ultrasound, including high-resolution ultrasonography and SWE, for asymptomatic ulnar nerve dislocation at cubital tunnel. In this prospective cross-sectional study, 41 participants were recruited in Shandong Provincial Hospital Affiliated to Shandong First Medical University in July 2022. The inclusion criteria for participants were being in good health and being 18-60 years of age. Meanwhile, the exclusion criterion was a history of upper limb pain or fractures, peripheral neuropathy, or systemic or immunological diseases. Finally, 38 participants were enrolled. Two ultrasound doctors measured the maximum diameter, the maximum cross-sectional area (CSA), and the shear modulus of the ulnar nerve at the cubital tunnel independently. Another two ultrasound doctors determined whether dislocation was present during dynamic elbow flexion and extension and divided the elbows into a dislocation group and a control group. The descriptive statistics and independent sample t-test were used for data analysis, and intragroup correlation coefficient (ICC) was used to determine the consistency of evaluation between observers. Ulnar nerve dislocation was observed in 15.8% (12/76) of the ulnar nerves. There was no significant difference in the maximum diameter between the dislocation group (0.194±0.022 cm) and the control group (0.181±0.023 cm) (t=1.888; P=0.063). The CSA and SWE of the ulnar nerve were 0.064±0.009 cm2 and 43.629±6.737 kPa in the dislocation group, respectively, and were 0.050±0.008 cm2 and 31.293±7.858 kPa in the control group, respectively. There were significant differences between the two groups in terms of CSA (P<0.001) and SWE (P<0.001). The ICCs of the maximum diameter, CSA, and SWE values between observers were 0.970, 0.900, and 0.915, respectively. Multimodal ultrasound consisting of high-resolution ultrasonography combined with elastography can comprehensively and quantitatively evaluate the morphological changes and mechanical properties of the dislocated ulnar nerve and monitor disease progress.

Reference Values of Nerve Cross-sectional Area Obtained by Ultrasound in the Upper Extremity Correlated with Electrodiagnosis in Thai Adults

OBJECTIVE To evaluate the ultrasonography cross-sectional area (CSA) reference values of nerves in the upper extremity correlated with electrodiagnosis in healthy Thai adults. METHODS A cross-sectional study was performed. Ninety participants were recruited and their CSA at 10 sites on the median, ulnar, and radial nerves were measured bilaterally. A nerve conduction study (NCS) was conducted and the correlations between the nerve CSA and age, sex, height, weight, body mass index (BMI), and NCS parameters were studied. RESULTS The mean CSA ranged from 5.8±1.4 to 9.5±1.5 mm2 along the median nerve and 4.5±0.8 to 7.7±1.7 mm2 along the ulnar nerve. The mean CSAs of the radial nerve at the elbow and spiral groove were 5.0±0.9 and 4.6±0.8 mm2, respectively. The CSA of the median nerve at the wrist and the CSA of the radial nerve at the spiral groove were positively correlated with weight and BMI, whereas the CSA of the median nerve at the elbow was positively correlated only with weight. There was an association between CSA values and electrodiagnosis parameters as the nerve CSA increased, as the latency was prolonged, and as the amplitude decreased. CONCLUSIONS The reference values of nerve CSA in the upper extremity at multiple sites can be helpful in the evaluation of peripheral nerve disorders in the Thai population. KEYWORDS cross-sectional area, ultrasonography, peripheral nerves, electrodiagnosis

Effect of strengthening and weakening of abdominal and dorsal muscles on lumbar spine loads in parents of disabled children

Pain in the lower part of the back is one of the most common chronic illnesses globally. This work aimed to determine the impact of the reinforcement of particular groups of abdominal and dorsal muscles on the loads exerted on the lumbar section of the spine in 30 mothers of children with motor disabilities. An optical Ariel Performance Analysis System recorded and processed the kinematics data of everyday activities. Tests investigating the effects of the strengthening or weakening of abdominal and dorsal muscles on loading in the lumbar section of the spine utilized the AnyBody Modelling System. Input data for the simulations included mean values of body positions, while the effects of strengthening or weakening of muscles were simulated in the muscle forces model by introducing different values for muscle physiological cross-sectional area (PCSA). Simulations used decreasing or increasing PCSA values of abdominal muscles and the erector spinae. The analysis involved component and resultant force values on the lumbosacral joint (L5-S1) of the spine and intra-abdominal pressure values. The highest reduction of the resultant reaction value in L5-S1 was observed in the simulations that increased the PCSA of the transverse abdominal (TrA). Indeed, a double increase in the TrA cross-section caused a reduction of the resultant reaction in L5-S1 by 30% and the anterior-posterior and proximal–distal forces by approximately 20–30%. Increased PCSA of the erector spinae exerted higher loads on the spine. These results indicate that strengthening weakened abdominal muscles, particularly TrA, in parents of children with motor disabilities reduces lower spinal loads during daily activities.

Abstract 11370: Comparing Coronary Artery Cross-Sectional Area Among Asymptomatic South Asian, White, and Black Participants: The Masala and Cardia Studies

Introduction: South Asian individuals have high risk of atherosclerotic cardiovascular disease (ASCVD). Some investigators suggest smaller coronary artery size may be partially responsible. Hypothesis: We hypothesized that South Asian participants would have smaller left anterior descending artery (LAD) cross sectional area (CSA) than Black and White participants, and that this association would be attenuated after adjusting for body size (BMI and height) and cardiovascular risk factors. Methods: We compared the LAD CSA (lumen and arterial wall) among South Asians in the Mediators of Atherosclerosis in South Asians Living in America study with White and Black participants in the Coronary Artery Risk Development in Young Adults study, adjusting for BMI, height, and other ASCVD risk factors. We used thin-slice non-contrast cardiac computed tomography to measure LAD CSA. We used linear regression models to explore differences by race/ethnicity in LAD CSA after adjusting for demographic, BMI, height, coronary artery calcium (CAC), and ASCVD risk factors. Results: We included 3,353 participants: 513 South Asian (44% women), 1286 Black (60% women), and 1554 White (54% women). After adjusting for age, BMI, height, there was no difference in LAD CSA between South Asian and White participants by sex. However, South Asian participants had smaller LAD CSA compared to Black participants by sex. After full adjustment for ASCVD risk factors, LAD CSA values were: South Asian women (19.9 mm 2 , 95% CI [18.8 - 20.9]) and men (22.3 mm 2 , 95% CI [21.4 - 23.2]; White women (20.0 mm 2 , 95% CI [19.4 - 20.5]) and men (23.6 mm 2 , 95% CI [23.0 - 24.2]); and Black women (21.6 mm 2 , 95% CI [21.0 - 22.2]) and men (26.0 mm 2 , 95% CI [25.3 - 26.7]) ( Figure 1 ). Conclusions: After accounting for differences in body size, South Asian participants had smaller LAD CSA compared to Black participants, but similar to White participants. Future studies should determine whether LAD CSA is associated with future ASCVD events.

Ultrasonic measurement for the diagnosis of cubital tunnel syndrome: A study in the Hong Kong Chinese population

Introduction: Ulnar nerve enlargement is observed in ultrasound (USG) in patients with cubital tunnel syndrome (CuTS). This study aims to compare the ultrasound size of the ulnar nerve between CuTS patients and control subjects, to find the cut off size for diagnosis, and to validate the use of USG as an adjunct in CuTS diagnosis. Materials and Methods: There were 23 elbows with clinical and nerve conduction test (NCT) confirmed CuTS, and 42 elbows in the control group. Cases with elbow deformities, old ulnar nerve injuries and postoperative cases were excluded. The ulnar nerve cross sectional area (CSA) was measured at 6 different levels and positions: over the medial epicondyle (ME) in elbow flexion/extension, 2 cm and 5 cm distal to the ME, 2 cm and 5 cm proximal to the ME. A cut off CSA value for CuTS diagnosis was derived. Correlation between ulnar nerve CSAs and NCT was analysed. Results: The age and gender distribution were similar in both groups (61.2 vs 56.6; M &gt; F, p &gt; 0.05). The mean CSA of the CuTS group vs control group was 19.2 mm2 vs 7.0 mm2, 19.5 mm2 vs 7.1 mm2, 20.8 mm2 vs 8.1 mm2 at ME flexion, ME extension and maximal CSA respectively. The derived CSA cut off value for CuTS at ME flexion, ME extension and maximal CSA were 10.5 mm2, 11.5 mm2, and 15 mm2 respectively. The CSA difference at different levels between the 2 groups were significant except at 5 cm proximal to ME. A strong negative correlation was seen between the CSA and the across elbow nerve conduction velocity, with correlation coefficient of −0.748 at ME flexion, −0.654 at ME extension and -0.676 at maximal CSA. Conclusion: USG can be used as an adjunct for the diagnosis of CuTS with high accuracy and patient safety. It can also be used to delineate possible anatomical etiologies at the cubital tunnel.

Cross-sectional area and fat infiltration of the lumbar spine muscles in patients with back disorders: a deep learning-based big data analysis.

Validated deep learning models represent a valuable option to perform large-scale research studies aiming to evaluate muscle quality and quantity of paravertebral lumbar muscles at the population level. This study aimed to assess lumbar spine muscle cross-sectional area (CSA) and fat infiltration (FI) in a large cohort of subjects with back disorders through a validated deep learning model. T2 axial MRI images of 4434 patients (n = 2609 females, n = 1825 males; mean age: 56.7 ± 16.8) with back disorders, such as fracture, spine surgery or herniation, were retrospectively collected from a clinical database and automatically segmented. CSA, expressed as the ratio between total muscle area (TMA) and the vertebral body area (VBA), and FI, in percentages, of psoas major, quadratus lumborum, erector spinae, and multifidus were analyzed as primary outcomes. Male subjects had significantly higher CSA (6.8 ± 1.7 vs. 5.9 ± 1.5 TMA/VBA; p < 0.001) and lower FI (21.9 ± 8.3% vs. 15.0 ± 7.3%; p < 0.001) than females. Multifidus had more FI (27.2 ± 10.6%; p < 0.001) than erector spinae (22.2 ± 9.7%), quadratus lumborum (17.5 ± 7.0%) and psoas (13.7 ± 5.8%) whereas CSA was higher in erector spinae than other lumbar muscles. A high positive correlation between age and total FI was detected (rs = 0.73; p < 0.001) whereas a negligible negative correlation between total CSA and age was observed (rs = - 0.24; p < 0.001). Subjects with fractures had lower CSA and higher FI compared to those with herniations, surgery and with no clear pathological conditions. CSA and FI values of paravertebral muscles vary a lot in accordance with subjects' sex, age and clinical conditions. Given also the large inter-muscle differences in CSA and FI, the choice of muscles needs to be considered with attention by spine surgeons or physiotherapists when investigating changes in lumbar muscle morphology in clinical practice.

Can Cochlear Nerve Size Assessment With Magnetic Resonance Enhance the Understanding of Idiopathic Sudden Sensorineural Hearing Loss?

Idiopathic sudden sensorineural hearing loss (ISSHL) is a rapid loss of hearing, exceeding 30 dB in at least 3 consecutive frequencies within 3 days, without any identifiable cause despite thorough investigations. Currently, the etiology and pathogenesis of ISSHL have not been fully elucidated. This study aimed to assess the size of the cochlear nerve in patients with ISSHL and explore its relationship with pretreatment audiograms and treatment response. Subjects and. A total of 125 patients (59 [47.2%] women; mean age 47.7±13.8 years [minimum-maximum: 21-76]) and 60 healthy participants (27 [45%] women; mean age 45.7±16.8 years [minimum-maximum: 20-76]) as a control group were included in this study. The size of the cochlear nerve was assessed on the affected side, compared to the control group, as well as on the unaffected side. Pretreatment and posttreatment audiological values were also analyzed. The cross-sectional area (CSA), vertical diameter (VD), and horizontal diameter (HD) of the CN were found to be smaller on the affected side of ISSHL patients compared to the control group (p<0.01; p=0.04; p=0.02, respectively). In the study group (affected side of ISSHL patients), there were no significant differences in VD, HD, and CSA values between pretreatment audiogram types (p=0.23; p=0.53; p=0.39, respectively), and initial hearing levels (p=0.16; p=0.22; p=0.23, respectively). Furthermore, there were no significant differences in VD, HD, and CSA values between the recovery groups according to Furuhashi criteria (p=0.18; p=0.37; p=0.27, respectively). The size of the CN may be a risk factor for ISSHL, but it does not affect the type of audiogram curves and was not prognostic in terms of treatment response.