Background

Echo intensity(EI) on ultrasonography images of skeletal muscle reflects muscle composition.

Objectives

The primary aim of the study was to investigate the inter-rater and test-retest reliability of EI using grayscale histogram analysis of the cross-sectional area of quadriceps femoris(QF) muscle in patients with knee osteoarthritis(KOA). The secondary aim of the study was to determine the concurrent validity of the Free Hand Tool(FHT) when compared to Rectangular Marquee Tool(RMT) for calculating the region of interest(ROI) in ImageJ.

Methods

This study included thirty patients with KOA. Echogenicity of the QF muscle were performed by two different raters. The reliability analysis was applied using intraclass correlation coefficient(ICC), standard error of measurement(SEM) and coefficient of variation(CV). Spearman rank correlation coefficients were calculated for assessing concurrent validity of the FHT to RMT. The Bland–Altman plots was used to show disagreement between tools. Wilcoxon signed-rank test was used for differences in assessments between test/retest sessions, raters, tools.

Results

The inter-rater and test-retest reliability of the EI using FHT and RMT was found to be excellent (ICC_FHT = 0.91–0.95, 0.98–0.99, ICC_RMT = 0.91–0.98, 0.91–0.99,respectively). Bland–Altman analysis demonstrated a slight bias when region ROI calculations were collected from RMT or FHT (bias ranging from 2.75 to−2.40 a. u). There were no significant differences between test/retest sessions, raters and tools(p > 0.05). Spearman correlation coefficient showed excellent correlation between tools used for echogenicity assessment of QF muscle(p < 0.001).

Conclusion

EI assessment using ultrasonography in the QF muscle showed excellent reliability. Evaluating muscle echogenicity using both FHT and RMT appears to be reliable and validity for monitoring muscle changes due to KOA.

中文翻译：

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膝骨关节炎患者股四头肌的超声成像：回声强度测量的重测和评估者间信度和同时效度

背景

骨骼肌超声图像上的回波强度 (EI) 反映了肌肉成分。

目标

本研究的主要目的是使用膝关节骨性关节炎 (KOA) 患者股四头肌 (QF) 肌肉横截面积的灰度直方图分析来研究 EI 的评分者间和重测信度。该研究的次要目的是确定与矩形选框工具 (RMT) 相比，徒手工具 (FHT) 在计算 ImageJ 中的感兴趣区域 (ROI) 时的并发有效性。

方法

该研究包括 30 名 KOA 患者。QF 肌肉的回声由两个不同的评估者进行。采用组内相关系数(ICC)、测量标准误差(SEM)和变异系数(CV)进行可靠性分析。计算斯皮尔曼等级相关系数以评估 FHT 与 RMT 的并发有效性。Bland-Altman 图用于显示工具之间的分歧。Wilcoxon 符号秩检验用于测试/重新测试会话、评分者、工具之间的评估差异。

结果

发现使用 FHT 和 RMT 的 EI 的评分者间和重测信度非常好（ICC _FHT  = 0.91-0.95、0.98-0.99，ICC _RMT  = 0.91-0.98、0.91-0.99，分别）。当从 RMT 或 FHT 收集区域 ROI 计算时，Bland-Altman 分析显示出轻微的偏差（偏差范围从 2.75 到−2.40 a. u）。测试/重新测试会话、评分者和工具之间没有显着差异（p > 0.05）。Spearman 相关系数显示用于 QF 肌肉回声评估的工具之间具有极好的相关性（p < 0.001）。

结论

在 QF 肌肉中使用超声检查的 EI 评估显示出极好的可靠性。使用 FHT 和 RMT 评估肌肉回声对于监测由 KOA 引起的肌肉变化似乎是可靠和有效的。