scholarly journals Intra-rater and inter-rater reliability of the process of obtaining cross-sectional area and echo intensity measurements of muscles from ultrasound images

2021 ◽  
Vol 21 (84) ◽  
pp. e7-e11
Author(s):  
Eric J. Sobolewski ◽  
◽  
Leah D. Wein ◽  
Jacquelyn M. Crow ◽  
Kaitlyn M. Carpenter ◽  
...  
Keyword(s):  
Vastus Lateralis ◽  
Measurement Techniques ◽  
Subcutaneous Fat ◽  
Cross Sectional Area ◽  
Muscle Quality ◽  
Ultrasound Images ◽  
Sectional Area ◽  
Echo Intensity ◽  
Cross Sectional ◽  
Rater Reliability

Introduction: The use of ultrasound images for analyzing muscle quality and size is continuing to grow in the literature. However, many of these manuscripts fail to properly describe their measurement techniques and steps involved in analyzing ultrasound images. Aim of this study: To evaluate the intra- and inter-rater reliability of the steps involved when analyzing ultrasound images to measure cross-sectional area and echo intensity. Material and methods: Twenty ultrasound images of the rectus femoris and vastus lateralis images were blinded and replicated, and then analyzed by experienced raters. The raters then were asked to analyze the images using open-source software for scaling measurements, subcutaneous fat thickness, cross-sectional area, and echo intensity. Matched image values for each measurement where compared for intra- and inter-rater reliability. Results: Intra-rater reliability ranged from fair (ICC3,1 = 0.32) to high (0.98), with echo intensity values being the least reliable (>0.55), and scaling and depth measurements being the most reliable (<0.85). Inter-rater reliability ranged from good (0.77) to high (0.97). Conclusion: Ultrasound- derived measures of cross-sectional area and echo intensity can be measured reliably, with echo intensity being the most difficult to replicate. However, reliability measures are unique to the rater and study and, therefore, should be clearly reported in every paper.

Muscle Quality, Measured by Ultrasound-Derived Corrected Echo Intensity, Does not Affect Changes in Cross-sectional Area of the Vastus Lateralis Following Recumbent Rest

2020 ◽  
pp. 875647932096727
Author(s):  
Alyssa N. Varanoske ◽  
Nicholas A. Coker ◽  
Bri-Ana D. I. Johnson ◽  
Tal Belity ◽  
Adam J. Wells
Keyword(s):  
Vastus Lateralis ◽  
Subcutaneous Fat ◽  
Morphological Characteristics ◽  
Time Frame ◽  
Cross Sectional Area ◽  
Muscle Quality ◽  
Muscle Size ◽  
Sectional Area ◽  
Echo Intensity ◽  
Cross Sectional

Objective: Recumbent rest elicits a decrease in muscle size of the lower extremity, but the extent of decrease may be related to differences in muscle quality. This could have implications for ultrasound-derived measures of muscle size, particularly in individuals with a large proportion of intramuscular contractile elements. The research objective was to determine whether decreases in muscle size following recumbent rest are related to ultrasound-derived corrected echo intensity in resistance-trained males. Methods: Cross-sectional area (CSA), echo intensity (EI), subcutaneous fat thickness (SFT), and EI corrected for SFT (EICor) of the vastus lateralis (VL) were measured via ultrasonography in 30 resistance-trained males. Measures were obtained immediately following recumbency (T0) and 15 minutes after recumbency (T15). The association between EICor and percentage change in CSA (%ΔCSA) from T0 to T15 was examined. Comparisons of morphological characteristics were examined between a subset of participants with the lowest (LO; n = 10; <33rd percentile) and highest (HI; n = 10; >66th percentile) EICor. Results: EICor was not correlated with %ΔCSA ( P = .151), and the decrease in CSA from T0 to T15 did not differ between the LO and HI groups. Conclusions: Muscle quality (EICor) is not related to the decrease in CSA of the VL following recumbent rest among resistance-trained, young males. The time frame of muscle CSA acquisition should not differ based solely on differences in muscle quality.

scholarly journals Declines in skeletal muscle quality vs. size following two weeks of knee joint immobilization

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8224 ◽  
Author(s):  
Rob J. MacLennan ◽  
Michael Sahebi ◽  
Nathan Becker ◽  
Ethan Davis ◽  
Jeanette M. Garcia ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Knee Joint ◽  
Vastus Lateralis ◽  
Rectus Femoris ◽  
Cross Sectional Area ◽  
Muscle Quality ◽  
Muscle Size ◽  
Sectional Area ◽  
Echo Intensity ◽  
Cross Sectional

Background Disuse of a muscle group, which occurs during bedrest, spaceflight, and limb immobilization, results in atrophy. It is unclear, however, if the magnitude of decline in skeletal muscle quality is similar to that for muscle size. The purpose of this study was to examine the effects of two weeks of knee joint immobilization on vastus lateralis and rectus femoris echo intensity and cross-sectional area. Methods Thirteen females (mean ± SD age = 21 ± 2 years) underwent two weeks of left knee joint immobilization via ambulating on crutches and use of a brace. B-mode ultrasonography was utilized to obtain transverse plane images of the immobilized and control vastus lateralis and rectus femoris at pretest and following immobilization. Effect size statistics and two-way repeated measures analyses of variance were used to interpret the data. Results No meaningful changes were demonstrated for the control limb and the rectus femoris of the immobilized limb. Analyses showed a large increase in vastus lateralis echo intensity (i.e., decreased muscle quality) for the immobilized limb (p = .006, Cohen’s d = .918). For vastus lateralis cross-sectional area, no time × limb interaction was observed (p = .103), but the effect size was moderate (d = .570). There was a significant association between the increase in vastus lateralis echo intensity and the decrease in cross-sectional area (r =  − .649, p = .016). Conclusion In female participants, two weeks of knee joint immobilization resulted in greater deterioration of muscle quality than muscle size. Echo intensity appears to be an attractive clinical tool for monitoring muscle quality during disuse.

scholarly journals DeepACSA: Automatic segmentation of anatomical cross-sectional area in ultrasound images of human lower limb muscles using deep learning

2021 ◽  
Author(s):  
Paul Ritsche ◽  
Philipp Wirth ◽  
Neil Cronin ◽  
Fabio Sarto ◽  
Marco Narici ◽  
...  
Keyword(s):  
Deep Learning ◽  
Lower Limb ◽  
Vastus Lateralis ◽  
Rectus Femoris ◽  
Cross Sectional Area ◽  
Mean Difference ◽  
Ultrasound Images ◽  
Sectional Area ◽  
Cross Sectional ◽  
Manual Analysis

Background: Muscle anatomical cross-sectional area (ACSA) is an important parameter that characterizes muscle function and helps to classify the severity of several muscular disorders. Ultrasound is a patient friendly, fast and cheap method of assessing muscle ACSA, but manual analysis of the images is laborious, subjective and requires thorough experience. To date, no open access and fully automated program to segment ACSA in ultrasound images is available. On this basis, we present DeepACSA, a deep learning approach to automatically segment ACSA in panoramic ultrasound images of the human rectus femoris (RF), vastus lateralis (VL), gastrocnemius medialis (GM) and lateralis (GL) muscles. Methods: We trained convolutional neural networks using 1772 ultrasound images from 153 participants (25 females, 128 males; mean age = 38.2 years, range: 13-78) captured by three experienced operators using three distinct devices. We trained three muscle-specific models to detect ACSA. Findings: Comparing DeepACSA analysis of the RF to manual analysis resulted in intra-class correlation (ICC) of 0.96 (95% CI 0.94,0.97), mean difference of 0.31 cm2 (0.04,0.58) and standard error of the differences (SEM) of 0.91 cm2 (0.47,1.36). For the VL, ICC was 0.94 (0.91,0.96), mean difference was 0.25 cm2 (-0.21,0.7) and SEM was 1.55 cm2 (1.13,1.96). The GM/GL muscles demonstrated an ICC of 0.97 (0.95,0.98), a mean difference of 0.01 cm2 (-0.25, 0.24) and a SEM of 0.69 cm2 (0.52,0.83). Interpretation: DeepACSA provides fast and objective segmentation of lower limb panoramic ultrasound images comparable to manual segmentation and is easy to implement both in research and clinical settings. Inaccurate model predictions occurred predominantly on low-quality images, highlighting the importance of high image quality for accurate prediction.

scholarly journals Ultrasound Imaging Analysis of the Lumbar Multifidus Muscle Echo Intensity: Intra-Rater and Inter-Rater Reliability of a Novice and an Experienced Rater

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 512
Author(s):  
Maryse Fortin ◽  
Brent Rosenstein ◽  
Jerome Levesque ◽  
Neil Nandlall
Keyword(s):  
Ultrasound Imaging ◽  
Muscle Quality ◽  
Ultrasound Images ◽  
Echo Intensity ◽  
Multifidus Muscle ◽  
Cross Sectional ◽  
Rater Reliability ◽  
Lumbar Multifidus ◽  
The Right ◽  
Lumbar Multifidus Muscle

Background and Objectives: Ultrasound echo intensity (EI) of the lumbar multifidus muscle (LMM) could offer valuable insights regarding muscle quality in people with low back pain (LBP). However, whether the rater’s experience noticeably influences the reliability and precision of LMM EI measurements has not been established. The aims of this study were to investigate the intra-rater and inter-rater reliability of LMM EI measurements, and to compare the reliability and SEM between a novice and an experienced rater. Materials and Methods: Twenty athletes (10 females, 10 males) with a history of LBP were included in this study. Transverse ultrasound images of LMM were taken at L5 in prone. LMM EI measurements were obtained bilaterally by tracing the maximum ROI representing the LMM cross-sectional area (CSA), avoiding the inclusion of bone or surrounding fascia. All measurements were performed by two novice raters and an experienced researcher. Each measurement was acquired by each rater three times for each side on three different images, and the average was used in the analyses. Raters were blinded to each other’s measurements and the participant’s clinical information. Intra-class correlation coefficients (ICCs) were obtained to assess the intra-rater and inter-rater reliability. Results: The intra-rater ICC values for the LMM measurements for the experienced rater were excellent (ICC all > 0.997). The inter-rater reliability ICC values showed moderate to excellent reliability (0.614 to 0.994) and agreement between the novice raters and the experienced rater, except for Novice 1 for the right LMM, which revealed lower ICCs and a wider 95% CI. Intra-rater and inter-rater reliability results were similar when separately looking at the right and left side of the muscle and participant gender. Conclusions: Our findings support the clinical use of ultrasound imaging for the assessment of LMM EI in individuals with LBP.

scholarly journals Test-Retest Reliability of Muscle Thickness, Echo-Intensity and Cross Sectional Area of Quadriceps and Hamstrings Muscle Groups Using B-mode Ultrasound

2017 ◽  
Vol 5 (1) ◽  
pp. 35 ◽  
Author(s):  
Cassio V. Ruas ◽  
Ronei S. Pinto ◽  
Camila D. Lima ◽  
Pablo B. Costa ◽  
Lee E. Brown
Keyword(s):  
Vastus Lateralis ◽  
Intraclass Correlation ◽  
Muscle Thickness ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Echo Intensity ◽  
Cross Sectional ◽  
Reliable Technique ◽  
Musculoskeletal Tissue ◽  
Muscle Groups

Ultrasound muscle images have been extensively used as tools for investigating, diagnosing and monitoring thigh muscles. However, there is a lack of information examining ultrasound reliability of quadriceps and hamstrings images for research and clinical use. Objectives: To determine the reliability of muscle thickness (MT), echo intensity (EI) and cross sectional area (CSA) of quadriceps and hamstrings muscle groups. Methods: Single transverse images of the rectus femoris (RF), vastus intermedius (VI), vastus medialis (VM), vastus lateralis (VL), biceps femoris long head (BFlh), semitendinosus (ST), and semimembranosus (SM) muscles were scanned in the right and left legs of ten healthy collegiate men (age 23.4 ± 2.2 yrs, mass 71.7 ± 11.7 kg, height 1.73 ± 0.06 m) between two sessions with one day interval. Intraclass correlation coefficients (ICCs), standard error of measurement (SEM), and minimum difference to be considered “real” (MD) were measured for MT, EI, and CSA. Results: A range of 0.97-0.99, 0.83-0.88, and 0.86-0.97 (ICC); 0.72-1.38, 2.73-3.41, and 0.36-1.04 (SEM); and 2.01-3.82, 7.56-9.46, and 0.99-2.89 (MD) were found for quadriceps muscles, and 0.93-0.99, 0.74-0.90, and 0.89-0.96 (ICC); 0.73-1.94, 3.29-4.98, and 0.69-1.08 (SEM); and 2.03-5.38, 9.13-13.81, and 1.91-2.98 (MD) were found for hamstrings muscles. Conclusions: These results suggest that ultrasound imaging of both quadriceps and hamstrings muscle architecture is a reliable technique for assessing thigh musculoskeletal tissue. The anatomical sites, as well as ultrasound adjustments, images, and results utilized here may assist future researchers and clinicians as reference tools when measuring quadriceps and hamstrings musculature. 

scholarly journals Seasonal Effects on Body Composition, Muscle Characteristics, and Performance of Collegiate Swimmers and Divers

2017 ◽  
Vol 52 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Erica J. Roelofs ◽  
Abbie E. Smith-Ryan ◽  
Eric T. Trexler ◽  
Katie R. Hirsch
Keyword(s):  
Body Composition ◽  
Lean Mass ◽  
Cross Sectional Area ◽  
Muscle Quality ◽  
Vastus Lateralis Muscle ◽  
Sectional Area ◽  
Echo Intensity ◽  
Cross Sectional ◽  
And Performance ◽  
Muscle Cross Sectional Area

Context: Previous researchers have indicated the importance of body composition and muscle quality in athletic performance. However, body composition and muscle-quality measures in swimmers and divers over a training season have yet to be evaluated. Objective: To identify changes in body composition and muscle characteristics over a competitive season and identify relationships between these variables and performance in National Collegiate Athletic Association Division I swimmers and divers. Design: Cross-sectional study. Setting: University laboratory. Patients or Other Participants: A total of 17 collegiate swimmers and divers (age = 18.6 ± 0.7 years, height = 175.8 ± 4.0 cm, body mass = 69.7 ± 7.0 kg). Main Outcome Measure(s): At preseason and postseason, body composition in each participant was assessed using dual-energy x-ray absorptiometry. Echo intensity and muscle cross-sectional area were determined from an ultrasound panoramic scan of the vastus lateralis muscle. Race times were obtained from the university athletic Web site. Results: Lean mass (P = .016), arm lean mass (P = .008), and muscle cross-sectional area (P = .03) were higher at postseason, whereas body fat percentage (P = .041) and echo intensity (P = .0007) were lower at postseason. Performance improved from preseason to postseason in all event groups (sprinters, distance swimmers, and divers; P &lt; .05). Conclusions: Body composition and muscle characteristics improved through 1 training season, which may have implications for performance. Quantifying body composition and muscle characteristics may be beneficial for professionals who work with athletes in order to improve performance and prevent injury.

scholarly journals ACSAuto-semi-automatic assessment of human vastus lateralis and rectus femoris cross-sectional area in ultrasound images

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paul Ritsche ◽  
Philipp Wirth ◽  
Martino V. Franchi ◽  
Oliver Faude
Keyword(s):  
Vastus Lateralis ◽  
Rectus Femoris ◽  
Cross Sectional Area ◽  
Ultrasound Images ◽  
Sectional Area ◽  
Automatic Assessment ◽  
Cross Sectional ◽  
Lower Limb Muscles ◽  
Standard Error Of Measurement ◽  
Error Of Measurement

AbstractOpen-access scripts to perform muscle anatomical cross-sectional area (ACSA) evaluation in ultrasound images are currently unavailable. This study presents a novel semi-automatic ImageJ script (named “ACSAuto”) for quantifying the ACSA of lower limb muscles. We compared manual ACSA measurements from 180 ultrasound scans of vastus lateralis (VL) and rectus femoris (RF) muscles to measurements assessed by the ACSAuto script. We investigated inter- and intra-investigator reliability of the script. Consecutive-pairwise intra-class correlations (ICC) and standard error of measurement (SEM) with 95% compatibility interval were calculated. Bland–Altman analyses were employed to test the agreement between measurements. Comparing manual and ACSAuto measurements, ICCs and SEMs ranged from 0.96 to 0.999 and 0.12 to 0.96 cm2 (1.2–5.9%) and mean bias was smaller than 0.5 cm2 (4.3%). Inter-investigator comparison revealed ICCs, SEMs and mean bias ranging from 0.85 to 0.999, 0.07 to 1.16 cm2 (0.9–7.6%) and − 0.16 to 0.66 cm2 (− 0.6 to 3.2%). Intra-investigator comparison revealed ICCs, SEMs and mean bias between 0.883–0.998, 0.07–0.93 cm2 (1.1–7.6%) and − 0.80 to 0.15 cm2 (− 3.4 to 1.8%). Image quality needs to be high for efficient and accurate ACSAuto analyses. Taken together, the ACSAuto script represents a reliable tool to measure RF and VL ACSA, is comparable to manual analysis and can reduce time needed to evaluate ultrasound images.

scholarly journals Ultrasonographic scoring system for superficial digital flexor tendon injuries in horses: intra- and inter-rater variability

2017 ◽  
Vol 181 (24) ◽  
pp. 655-655 ◽  
Author(s):  
Rafael Alzola Domingo ◽  
Chris M Riggs ◽  
David S Gardner ◽  
Sarah L Freeman
Keyword(s):  
Scoring System ◽  
Flexor Tendon ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Rater Agreement ◽  
Cross Sectional ◽  
Rater Reliability ◽  
Superficial Digital Flexor Tendon ◽  
Rater Variability ◽  
Fibre Pattern

Superficial digital flexor tendon (SDFT) tendinopathy is an important musculoskeletal problem in horses. The study objective was to validate an ultrasonographic scoring system for SDFT injuries. Ultrasonographic images from 14 Thoroughbred racehorses with SDFT lesions (seven core; seven diffuse) and two controls were blindly assessed by five clinicians on two occasions. Ultrasonographic parameters evaluated were: type and extent of the injury, location, echogenicity, cross-sectional area and longitudinal fibre pattern of the maximal injury zone (MIZ). Inter-rater variability and intra-rater reliability were assessed using Kendall’s coefficient of concordance (KC) and Lin’s concordance correlation coefficient (LC), respectively. Type of injury (core vs. diffuse) had perfect inter/intra-rater agreement. Cases with core lesions had very strong inter-rater agreement (KC ≥0.74, P<0.001) and intra-rater reliability (LC ≥0.73) for all parameters apart from echogenicity. Cases with diffuse lesions had strong inter-rater agreement (KC ≥0.62) for all parameters, but weak agreement for echogenicity (KC=0.22); intra-rater reliability was excellent for MIZ location and fibre pattern (LC ≥0.82), and moderate (LC ≥0.58) for cross-sectional area and number of zones affected. This scoring system was reliable and repeatable for all parameters, except for echogenicity. A validated scoring system will facilitate reliable recording of SDFT injuries and inter-study meta-analyses.

Intra- and inter-rater reliability for the measurement of the cross-sectional area of ankle tendons assessed by magnetic resonance imaging

2021 ◽  
pp. 028418512110032
Author(s):  
Henrique Mansur ◽  
Guilherme Estanislau ◽  
Marcos de Noronha ◽  
Rita de Cassia Marqueti ◽  
Emerson Fachin-Martins ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Repeated Measures ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Rater Reliability ◽  
The Cross ◽  
Very High

Background The cross-sectional area (CSA) records make an essential measurement for determining the mechanical properties of tendons, such as stress and strength. However, there is no consensus regarding the best method to record the CSA from different tendons. Purpose To determine intra- and inter-rater reliability for CSA measures from magnetic resonance imaging (MRI) of the following tendons: tibialis anterior; tibialis posterior; fibularis longus and brevis; and Achilles. Material and Methods We designed an observational study with repeated measures taken from a convenience sample of 20 participants diagnosed with acute or chronic ankle sprain. Two independent raters took three separate records from the CSA of ankle tendon images of each MRI slice. The intra-class correlation coefficient (ICC) and 95% limits of agreement (LoA) defined the quality (associations) and magnitude (differences), respectively, of intra- and inter-rater reliability on the measures plotted by the Bland–Altman method. Results Data showed very high intra- and inter-rater correlations for measures taken from all tendons analyzed (ICC 0.952–0.999). It also revealed an excellent agreement between raters (0.12%–2.3%), with bias no higher than 2 mm2 and LoA in the range of 4.4–7.9 mm2. The differences between repeated measures recorded from the thinnest tendons (fibularis longus and brevis) revealed the lowest bias and narrowest 95% LoA. Conclusion Reliability for the CSA of ankle tendons measured from MRI taken by independent rates was very high, with the smallest differences between raters observed when the thinnest tendon was analyzed.

Regulation of fiber size, oxidative potential, and capillarization in human muscle by resistance exercise

1999 ◽  
Vol 276 (2) ◽  
pp. R591-R596 ◽  
Author(s):  
H. Green ◽  
C. Goreham ◽  
J. Ouyang ◽  
M. Ball-Burnett ◽  
D. Ranney
Keyword(s):  
Fiber Type ◽  
Vastus Lateralis ◽  
Succinic Dehydrogenase ◽  
Quadriceps Muscle ◽  
Cellular Tissue ◽  
Cross Sectional Area ◽  
Fiber Types ◽  
Sectional Area ◽  
Oxidative Potential ◽  
Cross Sectional

To examine the hypothesis that increases in fiber cross-sectional area mediated by high-resistance training (HRT) would result in a decrease in fiber capillarization and oxidative potential, regardless of fiber type, we studied six untrained males (maximum oxygen consumption, 45.6 ± 2.3 ml ⋅ kg−1 ⋅ min−1; mean ± SE) participating in a 12-wk program designed to produce a progressive hypertrophy of the quadriceps muscle. The training sessions, which were conducted 3 times/wk, consisted of three sets of three exercises, each performed for 6–8 repetitions maximum (RM). Measurements of fiber-type distribution obtained from tissue extracted from the vastus lateralis at 0, 4, 7, and 12 wk indicated reductions ( P < 0.05) in type IIB fibers (15.1 ± 2.1% vs. 7.2 ± 1.3%) by 4 wk in the absence of changes in the other fiber types (types I, IIA, and IIAB). Training culminated in a 17% increase ( P < 0.05) in cross-sectional area by 12 wk with initial increases observed at 4 wk. The increase was independent of fiber type-specific changes. The number of capillaries in contact with each fiber type increased by 12 wk, whereas capillary contacts-to-fiber area ratios remained unchanged. In a defined cross-sectional field, HRT also increased the capillaries per fiber at 12 wk. Training failed to alter cellular oxidative potential, as measured by succinic dehydrogenase (SDH) activity, regardless of fiber type and training duration. It is concluded that modest hypertrophy induced by HRT does not compromise cellular tissue capillarization and oxidative potential regardless of fiber type.

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