Imaging of sarcopenia: old evidence and new insights
Imaging of sarcopenia: old evidence and new insights
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DOI：
10.1007/s00330-019-06573-2
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发表时间：
2020-04-01
影响因子：
5.9
通讯作者：
Sconfienza, Luca Maria
中科院分区：
文献类型：
--
作者：
Albano, Domenico;Messina, Carmelo;Sconfienza, Luca Maria
迄今为止，肌肉减少症被认为是能够预测临床结果的患者特异性成像生物标志物。几种成像方式，包括双能X射线吸收法（DXA），计算机断层扫描（CT），磁共振（MR）和超声（US），可用于评估肌肉质量和质量，并实现肌肉减少症的诊断。所有这些模式都可以提供不同程度的定量数据，因此具有可重复性和可比性。DXA是临床实践中最常用的一种，具有准确和广泛可用的优点，也是唯一具有公认的诊断骨骼肌减少症的截止值的放射学工具。CT和MR被认为是参考标准，可以评估肌肉质量和脂肪浸润，但它们的应用到目前为止主要限于研究。US一直被认为是肌肉减少症的次要工具，从未获得足够的空间。到目前为止，CT可能是最简单和最有前途的方式，虽然肌肉分割所需的时间很长。此外，由于CT测量的有效阈值的缺乏，未来的研究应该集中在这一点上。放射科医生有很大的潜力成为关键的背景下，肌肉减少症。我们高度掌握成像模式，并完全知道如何将其应用于不同的器官和临床场景。同样，放射科医生应该掌握肌肉减少症的文化，及其临床方面和患者护理的相关影响。放射医学和科学界应推动专门的教育课程，以提高专业人员的认识。
To date, sarcopenia is considered a patient-specific imaging biomarker able to predict clinical outcomes. Several imaging modalities, including dual-energy X-ray absorptiometry (DXA), computed tomography (CT), magnetic resonance (MR), and ultrasound (US), can be used to assess muscle mass and quality and to achieve the diagnosis of sarcopenia. With different extent, all these modalities can provide quantitative data, being thus reproducible and comparable over time. DXA is the one most commonly used in clinical practice, with the advantages of being accurate and widely available, and also being the only radiological tool with accepted cutoff values to diagnose sarcopenia. CT and MR are considered the reference standards, allowing the evaluation of muscle quality and fatty infiltration, but their application is so far mostly limited to research. US has been always regarded as a minor tool in sarcopenia and has never gained enough space. To date, CT is probably the easiest and most promising modality, although limited by the long time needed for muscle segmentation. Also, the absence of validated thresholds for CT measurements of myosteatosis requires that future studies should focus on this point. Radiologists have the great potential of becoming pivotal in the context of sarcopenia. We highly master imaging modalities and know perfectly how to apply them to different organs and clinical scenarios. Similarly, radiologists should master the culture of sarcopenia, and its clinical aspects and relevant implications for patient care. The medical and scientific radiological community should promote specific educational course to spread awareness among professionals.