Validity and reliability of a freehand 3D ultrasound system for the determination of triceps surae muscle volume in children with cerebral palsy
Validity and reliability of a freehand 3D ultrasound system for the determination of triceps surae muscle volume in children with cerebral palsy
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DOI：
10.1111/joa.12927
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发表时间：
2019-03-01
影响因子：
2.4
通讯作者：
Elliott, C.
中科院分区：
文献类型：
--
作者：
Barber, L.;Alexander, C.;Elliott, C.
本研究评估了使用单次扫描徒手3D超声（3DUS）对脑瘫儿童进行体内内侧腓肠肌（MG）、外侧腓肠肌（LG）和比目鱼肌（SOL）肌肉体积测量分割的有效性、评估者内和评估者间可靠性（CP）。对18例CP患儿（年龄8岁4个月± 1岁10个月，男性11例，单侧CP = 9例，双侧CP = 9例，粗大运动功能分类I = 11例，II = 7例）进行了徒手三维超声和磁共振成像（MRI）扫描。所有徒手3DUS和MRI图像均由两名评分员进行分割和体积绘制。使用一致性限方法评估有效性。使用组内相关（ICC）、变异系数（CV）和最小可检测变化（MDC）评估评定者内和评定者间信度。与MRI相比，徒手3DUS高估MG和LG的肌肉体积< 0.3 mL（1%），低估SOL < 1.3 mL（1.5%）。对于所有肌肉，徒手3DUS系统和MRI肌肉体积分割过程的评估者内可靠性的ICC分别> 0.98和0.99。对于所有肌肉，徒手3DUS和MRI体积分割过程的评分者间可靠性的ICC分别> 0.96和0.98。在所有肌肉中，单评估者徒手3DUS和MRI的MDC分别< 4.0 mL（14%）和3.2 mL（11%）。徒手3DUS是一种有效可靠的测量小腿肌肉体积的方法，可以在体内用单次扫描测量CP儿童的小腿肌肉体积。它可用作MRI的替代品，用于检测生长和干预导致的小腿肌肉体积的临床相关变化。
This study assessed the validity, intra-rater and inter-rater reliability of segmentation of in vivo medial gastrocnemius (MG), lateral gastrocnemius (LG) and soleus (SOL) muscle volume measurement using a single sweep freehand 3D ultrasound (3DUS) in children with cerebral palsy (CP). The MG, LG and SOL of both limbs of 18 children with CP (age 8 years 4 months +/- 1 year 10 months, 11 males, unilateral CP = 9, bilateral CP = 9, Gross Motor Functional Classification System I = 11, II = 7) were scanned using freehand 3DUS and magnetic resonance imaging (MRI). All freehand 3DUS and MRI images were segmented and volumes rendered by two raters. Validity was assessed using limits of agreement method. Intra-rater and inter-rater reliability was assessed using intra-class correlation (ICC), coefficient of variance (CV) and minimal detectable change (MDC). Freehand 3DUS overestimated muscle volume of the MG and LG by < 0.3 mL (1%) and underestimated SOL by < 1.3 mL (1.5%) compared with MRI. ICCs for intra-rater reliability of the segmentation process for the freehand 3DUS system and MRI for muscle volume were > 0.98 and 0.99, respectively, for all muscles. ICCs for inter-rater reliability of the segmentation process for freehand 3DUS and MRI volumes were > 0.96 and 0.98, respectively, for all muscles. MDCs for single rater freehand 3DUS and MRI were < 4.0 mL (14%) and 3.2 mL (11%), respectively, in all muscles. Freehand 3DUS is a valid and reliable method for the measurement of lower leg muscle volume that can be measured with a single sweep in children with CP in vivo. It can be used as an alternative to MRI for the detection of clinically relevant changes in calf muscle volume as the result of growth and interventions.