Cross-sectional area and fat content in dachshund epaxial muscles: an MRI and CT reliability study

MRI and CT are frequently used to diagnose spinal diseases in dogs. These modalities have detected epaxial muscle degeneration in dachshunds with intervertebral disc herniation. However, research on the reliability of epaxial muscular measurements is limited in veterinary medicine. The aims of the study were to assess the intrarater and inter-rater reliability of epaxial muscle cross-sectional area (CSA) and fat content measurements on MRI and CT images in dachshunds, and to compare the CSA measurement between the two modalities. MRI and CT images of 10 healthy dachshunds were evaluated. Two blinded observers assessed MRI CSA, MRI fat content, CT CSA and CT muscle attenuation of three thoracolumbar epaxial muscles using OsiriX. The results showed ‘substantial’ to ‘almost perfect’ intrarater reliability (intraclass correlation coefficient (ICC) 0.828–0.998) and inter-rater reliability (ICC 0.685–0.854) for all variables. When individual spinal segments were analysed, the intrarater and inter-rater reliability decreased and the confidence intervals increased. There was positive correlation (r= 0.719–0.841, P=0.001) and high agreement (0.824–0.894) for the measured CSA between MRI and CT. Epaxial muscle CSA and fat content can be reliably measured on MRI and CT, bearing in mind that measurement of certain segments requires adequate training.

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Intra- and inter-rater reliability in the cross-sectional area of feline lumbar epaxial musculature evaluated via abdominal CT scan

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x19880997 ◽

2019 ◽

Vol 22 (8) ◽

pp. 721-728

Author(s):

Laura H Rayhel ◽

Jessica M Quimby ◽

Eric M Green ◽

Valerie J Parker ◽

Shasha Bai

Keyword(s):

Ct Scan ◽

Muscle Mass ◽

Ct Images ◽

Cross Sectional Area ◽

Area Measurement ◽

Thoracic Vertebrae ◽

Sectional Area ◽

Cross Sectional ◽

Rater Reliability ◽

Epaxial Muscle

Objectives The aim of this study was to evaluate the intra- and inter-rater reliability of epaxial muscle cross-sectional area measurement on feline CT images and to determine the relationship between normalized epaxial muscle area (EMA) and subjective muscle condition score (MCS). Methods Feline transverse CT images including the junction of the 13th thoracic vertebrae/13th rib head were retrospectively reviewed. Right and left epaxial muscle circumference and vertebral body height were measured and an average normalized EMA (ratio of epaxial area:vertebral height) was calculated for each image. Measurements were performed by three individuals blinded to the clinical data and were repeated 1 month later. Intra- and inter-rater reliability of EMA was assessed with concordance correlation coefficient (CCC), and Bland–Altman analysis was performed to assess bias and limits of agreement (LoA) between and within observers at different time points. In cats for which MCS data were available, EMA was compared between differing MCSs via the Kruskal–Wallis test, with Bonferroni-corrected Wilcoxon rank-sum post-hoc analysis. Results In total, 101 CT scans met the inclusion criteria for reliability analysis, 29 of which had muscle condition information available for analysis. Intra-rater EMA CCC ranged from 0.84 to 0.99 with minimal bias (range –0.16 to 0.08) and narrow LoA. Inter-rater EMA CCC ranged from 0.87 to 0.94, bias was larger (range –0.46 to 0.66) and LoA were wider when assessed between observers. Median EMA was significantly lower in cats with severe muscle atrophy (2.76, range 1.28–3.96) than in all other MCS groups ( P <0.0001 for all comparisons). Conclusions and relevance Measurement of EMA on CT showed strong intra-rater reliability, and median EMA measurements were significantly lower in cats with severe muscle wasting, as assessed on physical examination. Further studies correlating EMA to lean muscle mass in cats are needed to determine whether this method may be useful to quantify muscle mass in patients undergoing a CT scan.

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Ultrasonographic scoring system for superficial digital flexor tendon injuries in horses: intra- and inter-rater variability

Veterinary Record ◽

10.1136/vr.104233 ◽

2017 ◽

Vol 181 (24) ◽

pp. 655-655 ◽

Cited By ~ 1

Author(s):

Rafael Alzola Domingo ◽

Chris M Riggs ◽

David S Gardner ◽

Sarah L Freeman

Keyword(s):

Scoring System ◽

Flexor Tendon ◽

Cross Sectional Area ◽

Sectional Area ◽

Rater Agreement ◽

Cross Sectional ◽

Rater Reliability ◽

Superficial Digital Flexor Tendon ◽

Rater Variability ◽

Fibre Pattern

Superficial digital flexor tendon (SDFT) tendinopathy is an important musculoskeletal problem in horses. The study objective was to validate an ultrasonographic scoring system for SDFT injuries. Ultrasonographic images from 14 Thoroughbred racehorses with SDFT lesions (seven core; seven diffuse) and two controls were blindly assessed by five clinicians on two occasions. Ultrasonographic parameters evaluated were: type and extent of the injury, location, echogenicity, cross-sectional area and longitudinal fibre pattern of the maximal injury zone (MIZ). Inter-rater variability and intra-rater reliability were assessed using Kendall’s coefficient of concordance (KC) and Lin’s concordance correlation coefficient (LC), respectively. Type of injury (core vs. diffuse) had perfect inter/intra-rater agreement. Cases with core lesions had very strong inter-rater agreement (KC ≥0.74, P<0.001) and intra-rater reliability (LC ≥0.73) for all parameters apart from echogenicity. Cases with diffuse lesions had strong inter-rater agreement (KC ≥0.62) for all parameters, but weak agreement for echogenicity (KC=0.22); intra-rater reliability was excellent for MIZ location and fibre pattern (LC ≥0.82), and moderate (LC ≥0.58) for cross-sectional area and number of zones affected. This scoring system was reliable and repeatable for all parameters, except for echogenicity. A validated scoring system will facilitate reliable recording of SDFT injuries and inter-study meta-analyses.

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Intra- and inter-rater reliability for the measurement of the cross-sectional area of ankle tendons assessed by magnetic resonance imaging

Acta Radiologica ◽

10.1177/02841851211003284 ◽

2021 ◽

pp. 028418512110032

Author(s):

Henrique Mansur ◽

Guilherme Estanislau ◽

Marcos de Noronha ◽

Rita de Cassia Marqueti ◽

Emerson Fachin-Martins ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Repeated Measures ◽

Cross Sectional Area ◽

Sectional Area ◽

Resonance Imaging ◽

Cross Sectional ◽

Rater Reliability ◽

The Cross ◽

Very High

Background The cross-sectional area (CSA) records make an essential measurement for determining the mechanical properties of tendons, such as stress and strength. However, there is no consensus regarding the best method to record the CSA from different tendons. Purpose To determine intra- and inter-rater reliability for CSA measures from magnetic resonance imaging (MRI) of the following tendons: tibialis anterior; tibialis posterior; fibularis longus and brevis; and Achilles. Material and Methods We designed an observational study with repeated measures taken from a convenience sample of 20 participants diagnosed with acute or chronic ankle sprain. Two independent raters took three separate records from the CSA of ankle tendon images of each MRI slice. The intra-class correlation coefficient (ICC) and 95% limits of agreement (LoA) defined the quality (associations) and magnitude (differences), respectively, of intra- and inter-rater reliability on the measures plotted by the Bland–Altman method. Results Data showed very high intra- and inter-rater correlations for measures taken from all tendons analyzed (ICC 0.952–0.999). It also revealed an excellent agreement between raters (0.12%–2.3%), with bias no higher than 2 mm2 and LoA in the range of 4.4–7.9 mm2. The differences between repeated measures recorded from the thinnest tendons (fibularis longus and brevis) revealed the lowest bias and narrowest 95% LoA. Conclusion Reliability for the CSA of ankle tendons measured from MRI taken by independent rates was very high, with the smallest differences between raters observed when the thinnest tendon was analyzed.

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Comparison of Muscle Cross-sectional Area and Lumbar Muscle Strength According to Degenerative Spinal Diseases

The Asian Journal of Kinesiology ◽

10.15758/ajk.2020.22.2.1 ◽

2020 ◽

Vol 22 (2) ◽

pp. 1-10

Author(s):

Ji-Hoon Cho ◽

Ki-Hyuk Lee ◽

Seung-Taek Lim ◽

Buong-O Chun

Keyword(s):

Muscle Strength ◽

Cross Sectional Area ◽

Spinal Diseases ◽

Sectional Area ◽

Multifidus Muscle ◽

Cross Sectional ◽

Total Group ◽

Male Group ◽

The Difference ◽

Lumbar Extension

OBJECTIVES The purpose of this study was to investigate the difference in the cross - sectional area (CSA) of multifidus and Iliopsoas muscles and the lumbar extension muscle strength according to degenerative spinal diseases (LHI; lumbar herniation of intervertebral disc group, SS; spinal stenosis group, S; spondylolisthesis group).METHODS The CSA of multifidus and Iliopsoas muscles size were measured by PACS(Picture Achiving and Communication System) using MRI at the L4/5 level and lumbar extension muscle strength (72˚, 60˚, 48˚, 36˚, 24˚, 12˚, 0˚) was measured using lumbar extension machine(MedX) in 97 patients of degenerative spinal diseases(male: 57, female: 40). The collected data were analyzed by one-way ANOVA using the SPSS program.RESULTS The results of this study showed that the CSA of total and right multifidus muscle in the LHI was significantly higher than that of the S (p <.05; p <.05) in the male group. The difference between the left and right CSA of multifidus in the LHI group was significantly higher than that of the SS (p <.05) in the male group (p <.05) and total group (p <.05). The CSA of iliopsoas muscle in the S was significantly higher than that of the LHI in the male and total group (p <.05; p <.05). In case of lumbar extension muscle strength, the S showed significantly higher muscle strength at 36 and 48 degrees than that of the SS in the male group. In the total group, LHI showed significantly higher muscle strength at 60 degrees of lumbar extension muscle strength than that of the S.CONCLUSION Multifidus muscle appears to be a key factor in prevention and treatment intervention in low back pain patients. In particular, in the case of S group, exercise therapy for strengthening the multifidus muscle is need for the rehabilitation.

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Altered Body Composition of Psoas and Thigh Muscles in Relation to Frailty and Severity of Parkinson's Disease

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16193667 ◽

2019 ◽

Vol 16 (19) ◽

pp. 3667 ◽

Cited By ~ 2

Author(s):

Chiang ◽

Chen ◽

Lin

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Severity ◽

Fat Content ◽

Cross Sectional Area ◽

Muscle Quality ◽

Sectional Area ◽

Cross Sectional ◽

Thigh Muscles ◽

Fat Fraction

Background: To investigate the relationship between fat content and the cross-sectional area of psoas and thigh muscles, and clinical severity in patients with Parkinson’s disease. Materials and Methods: Twenty-five patients and 20 age- and sex-matched normal controls were recruited. All subjects underwent MRI study to determine the fat content of the bilateral psoas and thigh muscles. Muscle quality was measured by grasp, walking speed, and cross-sectional area. All patients underwent clinical surveys to evaluate disease severity and frailty, and analyses of the correlations between muscle quality and disease severity were performed. Results: Compared with the controls, patients exhibited higher fatty content in the measured muscles. The higher fat infiltration of measured muscles was significantly correlated with increased disease severity and frailty in patients. The fat fraction of the bilateral medial compartment of the thigh was correlated with the Unified Parkinson Disease Rating Scale-I results and the fat fraction of the bilateral anterior compartment of the thigh was correlated with weakness and exhaustion in patients. Conclusions: Decreased quality in psoas and thigh muscles is prominent in Parkinson’s disease which is further associated with disease severity and frailty. Awareness of the risk of sarcopenia and associated sequelae might improve patient care and outcomes.

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Usefulness of Coronal Reconstruction CT Images for Quantitative Evaluation of the Cross-Sectional Area of Small Pulmonary Vessels

Academic Radiology ◽

10.1016/j.acra.2014.05.024 ◽

2014 ◽

Vol 21 (11) ◽

pp. 1411-1415 ◽

Cited By ~ 4

Author(s):

Shin Matsuoka ◽

Tsuneo Yamashiro ◽

Shoichiro Matsushita ◽

Akiyuki Kotoku ◽

Atsuko Fujikawa ◽

...

Keyword(s):

Quantitative Evaluation ◽

Ct Images ◽

Cross Sectional Area ◽

Sectional Area ◽

Cross Sectional ◽

Pulmonary Vessels ◽

The Cross

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Assessing lumbar paraspinal muscle cross-sectional area and fat composition with T1 versus T2-weighted magnetic resonance imaging: Reliability and concurrent validity

PLoS ONE ◽

10.1371/journal.pone.0244633 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0244633

Author(s):

J. R. Cooley ◽

J. J. Hebert ◽

A. de Zoete ◽

T. S. Jensen ◽

P. R. Algra ◽

...

Keyword(s):

Concurrent Validity ◽

Cross Sectional Area ◽

Sectional Area ◽

Resonance Imaging ◽

Limits Of Agreement ◽

Cross Sectional ◽

Rater Reliability ◽

Lumbar Multifidus ◽

Total Cross Sectional Area ◽

Weighted Sequences

Purpose Studies using magnetic resonance imaging to assess lumbar multifidus cross-sectional area frequently utilize T1 or T2-weighted sequences, but seldom provide the rationale for their sequence choice. However, technical considerations between their acquisition protocols could impact on the ability to assess lumbar multifidus anatomy or its fat/muscle distinction. Our objectives were to examine the concurrent validity of lumbar multifidus morphology measures of T2 compared to T1-weighted sequences, and to assess the reliability of repeated lumbar multifidus measures. Methods The lumbar multifidus total cross-sectional area of 45 patients was measured bilaterally at L4 and L5, with histogram analysis determining the muscle/fat threshold values per muscle. Images were later re-randomized and re-assessed for intra-rater reliability. Matched images were visually rated for consistency of outlining between both image sequences. Bland-Altman bias, limits of agreement, and plots were calculated for differences in total cross-sectional area and percentage fat between and within sequences, and intra-rater reliability analysed. Results T1-weighted total cross-sectional area measures were systematically larger than T2 (0.2 cm2), with limits of agreement <±10% at both spinal levels. For percentage fat, no systematic bias occurred, but limits of agreement approached ±15%. Visually, muscle outlining was consistent between sequences, with substantial mismatches occurring in <5% of cases. Intra-rater reliability was excellent (ICC: 0.981–0.998); with bias and limits of agreement less than 1% and ±5%, respectively. Conclusion Total cross-sectional area measures and outlining of muscle boundaries were consistent between sequences, and intra-rater reliability for total cross-sectional area and percentage fat was high indicating that either MRI sequence could be used interchangeably for this purpose. However, further studies comparing the accuracy of various methods for distinguishing fat from muscle are recommended.

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Intra-rater and inter-rater reliability of the process of obtaining cross-sectional area and echo intensity measurements of muscles from ultrasound images

Journal of Ultrasonography ◽

10.15557/jou.2021.0002 ◽

2021 ◽

Vol 21 (84) ◽

pp. e7-e11

Author(s):

Eric J. Sobolewski ◽

◽

Leah D. Wein ◽

Jacquelyn M. Crow ◽

Kaitlyn M. Carpenter ◽

...

Keyword(s):

Vastus Lateralis ◽

Measurement Techniques ◽

Subcutaneous Fat ◽

Cross Sectional Area ◽

Muscle Quality ◽

Ultrasound Images ◽

Sectional Area ◽

Echo Intensity ◽

Cross Sectional ◽

Rater Reliability

Introduction: The use of ultrasound images for analyzing muscle quality and size is continuing to grow in the literature. However, many of these manuscripts fail to properly describe their measurement techniques and steps involved in analyzing ultrasound images. Aim of this study: To evaluate the intra- and inter-rater reliability of the steps involved when analyzing ultrasound images to measure cross-sectional area and echo intensity. Material and methods: Twenty ultrasound images of the rectus femoris and vastus lateralis images were blinded and replicated, and then analyzed by experienced raters. The raters then were asked to analyze the images using open-source software for scaling measurements, subcutaneous fat thickness, cross-sectional area, and echo intensity. Matched image values for each measurement where compared for intra- and inter-rater reliability. Results: Intra-rater reliability ranged from fair (ICC3,1 = 0.32) to high (0.98), with echo intensity values being the least reliable (>0.55), and scaling and depth measurements being the most reliable (<0.85). Inter-rater reliability ranged from good (0.77) to high (0.97). Conclusion: Ultrasound- derived measures of cross-sectional area and echo intensity can be measured reliably, with echo intensity being the most difficult to replicate. However, reliability measures are unique to the rater and study and, therefore, should be clearly reported in every paper.

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