Computed tomography (CT) is a valuable assessment method for muscle pathologies such as sarcopenia, cachexia, and myosteatosis. However, several key underappreciated scan imaging parameters need consideration for both research and clinical use, specifically CT kilovoltage and the use of contrast material. We conducted a scoping review to assess these effects on CT muscle measures. We reviewed articles from PubMed, Scopus, and Web of Science from 1970 to 2020 on the effect of intravenous contrast material and variation in CT kilovoltage on muscle mass and density. We identified 971 articles on contrast and 277 articles on kilovoltage. The number of articles that met inclusion criteria for contrast and kilovoltage was 11 and 7, respectively. Ten studies evaluated the effect of contrast on muscle density of which nine found that contrast significantly increases CT muscle density (arterial phase 6–23% increase, venous phase 19–57% increase, and delayed phase 23–43% increase). Seven out of 10 studies evaluating the effect of contrast on muscle area found significant increases in area due to contrast (≤2.58%). Six studies evaluating kilovoltage on muscle density found that lower kilovoltage resulted in a higher muscle density (14–40% increase). One study reported a significant decrease in muscle area when reducing kilovoltage (2.9%). The use of contrast and kilovoltage variations can have dramatic effects on skeletal muscle analysis and should be considered and reported in CT muscle analysis research. These significant factors in CT skeletal muscle analysis can alter clinical and research outcomes and are therefore a barrier to clinical application unless better appreciated.

中文翻译：

---

计算机断层扫描参数对肌肉减少症和肌肉脂肪变性评估的影响：范围界定审查

计算机断层扫描 (CT) 是一种有价值的肌肉病变评估方法，例如肌肉减少症、恶病质和肌肉脂肪变性。然而，研究和临床使用需要考虑几个关键的未被充分认识的扫描成像参数，特别是 CT 千伏和造影剂的使用。我们进行了范围界定审查，以评估这些对 CT 肌肉测量的影响。我们回顾了 1970 年至 2020 年 PubMed、Scopus 和 Web of Science 中关于静脉注射造影剂和 CT 千伏电压变化对肌肉质量和密度的影响的文章。我们确定了 971 篇关于对比的文章和 277 篇关于千伏的文章。符合对比度和千伏纳入标准的文章数量分别为 11 篇和 7 篇。十项研究评估了对比对肌肉密度的影响，其中九项发现对比显着增加了 CT 肌肉密度（动脉期增加 6-23%，静脉期增加 19-57%，延迟期增加 23-43%）。在评估对比度对肌肉面积影响的 10 项研究中，有 7 项发现由于对比度 (≤2.58%)，肌肉面积显着增加。六项评估千电压对肌肉密度影响的研究发现，较低的千电压会导致较高的肌肉密度（增加 14-40%）。一项研究报告说，当降低千伏电压时，肌肉面积会显着减少 (2.9%)。对比度和千伏变化的使用会对骨骼肌分析产生显着影响，应在 CT 肌肉分析研究中加以考虑和报告。