title: Ultrasound characterization of medial gastrocnemius tissue composition in children with spastic cerebral palsy.
abstract: BACKGROUND
  In this study we aimed to characterize muscle composition of the medial gastrocnemius in children with spastic cerebral palsy (SCP) using quantitative ultrasound.
  
  
  METHODS
  Forty children with SCP, aged 4-14 years, participated in this study. Children were grouped according to the gross motor function classification system (GMFCS I-V) and compared with a cohort of age- and gender-matched, typically developing children (TD; n = 12). Ultrasound scans were taken of the medial gastrocnemius. Images were then characterized using grayscale statistics to determine mean echo intensity (EI) and the size and number of spatially connected homogeneous regions (i.e., blobs).
  
  
  RESULTS
  Significant differences in skeletal muscle composition were found between children with SCP and their TD peers. Children classified as GMFCS III consistently exhibited the highest EI and blob area.
  
  
  CONCLUSIONS
  This study demonstrates altered tissue composition in children with SCP visualized using ultrasound. Further work is required to determine the pathophysiology contributing to these alterations in SCP.
authors.affiliation: School of Sport Science, Exercise and Health, The University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia, Australia.
authors.forename: Christian A
authors.initials: CA
authors.lastname: Pitcher
authors.affiliation: Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Elliott
authors.affiliation: School of Engineering and Applied Sciences, Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA.
authors.forename: Fausto A
authors.initials: FA
authors.lastname: Panizzolo
authors.affiliation: Department of Paediatric Rehabilitation, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
authors.forename: Jane P
authors.initials: JP
authors.lastname: Valentine
authors.affiliation: Department of Orthopaedics, Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
authors.forename: Katherine
authors.initials: K
authors.lastname: Stannage
authors.affiliation: School of Sport Science, Exercise and Health, The University of Western Australia, 35 Stirling Highway, Crawley, 6009, Western Australia, Australia.
authors.forename: Siobhán L
authors.initials: SL
authors.lastname: Reid
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000627:therapeutic use; D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging*; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A
keywords: children; gross motor function; mean echo intensity; quantitative muscle ultrasound; spastic cerebral palsy; ultrasound