Visual assessment of segmental muscle ultrasound images in spina bifida aperta.
In spina bifida aperta (SBA), spinal MRI provides a surrogate marker to estimate muscle damage caudal to the myelomeningocele (MMC). This muscle damage by the MMC can be quantified by intra-individual comparison of muscle ultrasound density (MUD) caudal versus cranial to the MMC (dMUD = [MUD(caudal-to-the-MMC)] - [MUD(cranial-to-the-MMC)]). Quantitative dMUD assessment requires time, equipment and expertise, whereas it could also be visually determined by differences in muscle echodensity caudal vs. cranial to the MMC (visual-dMUD). If visual and quantitative dMUD correspond, visual dMUD assessment could provide a clinical screening parameter. In 100 SBA muscle ultrasound recordings of patients with various MMC levels, we aimed to compare quantitative dMUD (dMUD = [MUD(calf-muscle/S1)] - [MUD(quadriceps-muscle/L2-L4)]) with visual dMUD assessments by 20 different observers. Results indicate that quantitative dMUD can be visually detected (sensitivity 86%; specificity 57%), implicating that visual dMUD screening could provide a quick, clinical screening tool for muscle impairment by the MMC.
Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Rick
R
Brandsma
Renate J
RJ
Verbeek
Natasha M
NM
Maurits
Janneke T
JT
Hamminga
Oebele F
OF
Brouwer
Johannes H
JH
van der Hoeven
Huibert
H
Burger
Deborah A
DA
Sival
D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging*; D009135:Muscular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016137:Spina Bifida Cystica / Q000150:complications* / Q000000981:diagnostic imaging*; D014463:Ultrasonography