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

2017 ◽  
Vol 181 (24) ◽  
pp. 655-655 ◽  
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.

Morphologic and morphometric features of the calcaneal insertions of the superficial digital flexor tendon in the horse

2014 ◽  
Vol 27 (05) ◽  
pp. 366-371 ◽  
Author(s):  
I. M. Wright ◽  
W. H. J. Barker
Keyword(s):  
Flexor Tendon ◽  
Biceps Femoris ◽  
Cross Sectional Area ◽  
T Test ◽  
Sectional Area ◽  
Cross Sectional ◽  
Plantar Surface ◽  
Paired Student ◽  
Morphometric Features ◽  
Superficial Digital Flexor Tendon

SummaryIntroduction: Accurate description of the calcaneal insertions of the superficial digital flexor tendon (SDFT) is lacking and inconsistent. The aim of this study was to undertake morphologic and morphometic evaluations of these structures to assist in elucidating their functional and pathogenic roles in displacement of the SDFT from the calcaneal tuber.Method: Dissections were performed on 10 normal cadaveric hindlimbs. The anatomy was photographed to allow measurements at repeatable locations and differences in SDFT dimensions at the various locations were compared using a paired student t-test.Results: This study demonstrated that the calcaneal insertions of the SDFT are independent from the overlying tarsal insertions of the biceps femoris and semitendinosus, which blend into the plantar surface of the fibrocartilaginous cap (FCC) of the SDFT before inserting dorsal to the insertion of the SDFT on the calcaneal tuber. The lateral insertion of the SDFT is larger in cross-sectional area (median: 219 mm2) at its origin from the FCC than its medial counterpart (median: 159 mm2, p = 0.004) and has a more complex fibre alignment. The lateral site of attachment of the SDFT on the calcaneal tuber is dorsolateral to the insertion of the gastrocnemius tendon and is larger (median: 525 mm2) than the medial insertion (median: 428 mm2, p = 0.036), which inserts distal to the insertion of the gastrocnemius tendon.Conclusion: The features identified in this study suggest that the calcaneal insertions of the SDFT are complex and their morphological and morphometric differences are likely to contribute to clinical lesions identified at this site.

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

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.

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

2018 ◽  
Vol 5 (1) ◽  
pp. e000256 ◽  
Author(s):  
Anna Fredrika Boström ◽  
Anu K Lappalainen ◽  
Lieven Danneels ◽  
Tarja S Jokinen ◽  
Outi Laitinen-Vapaavuori ◽  
...  
Keyword(s):  
Ct Images ◽  
Fat Content ◽  
Cross Sectional Area ◽  
Spinal Diseases ◽  
Intervertebral Disc Herniation ◽  
Sectional Area ◽  
Cross Sectional ◽  
Rater Reliability ◽  
Epaxial Muscles ◽  
Epaxial Muscle

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.

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

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.

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

PLoS ONE ◽  
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.

Cross sectional area of forelimb metacarpal region flexor tendons in horses of different breeds and age

2014 ◽  
Vol 10 (3) ◽  
pp. 187-198
Author(s):  
A. Lindner ◽  
A. Köster
Keyword(s):  
Flexor Tendon ◽  
Age Groups ◽  
Metacarpophalangeal Joint ◽  
Cross Sectional Area ◽  
Carpal Bone ◽  
Sectional Area ◽  
Cross Sectional ◽  
Flexor Tendons ◽  
Distal Border ◽  
The Right

There are few studies on the effects of age within breeds on cross sectional area (CSA) of flexor tendons in horses. This study was designed to evaluate the relationship between age and the CSA of the superficial flexor tendon (SDFT), the deep digital flexor tendon (DDFT) and its accessory ligament (AL-DDFT) of both forelimbs in horses utilising ultrasound. Ages of the horses ranged from 2 years to aged, and the breeds evaluated were Thoroughbred (TB), Standardbred (SB), Quarterhorse (QH) and German Warmblood Riding horse (WB). CSAs were measured with ultrasound at 4 cm intervals, starting 4 cm from the distal border of the accessory carpal bone down to the metacarpophalangeal joint. The CSA of the SDFT in 3-year-old and older TB, QH and WBs was smaller than in the 2-year-olds (all P<0.001) and did not differ between 3-year-olds and older horses (P≯0.05). In comparison, the CSA of the SDFT in 2-year-old and 3-year-old SBs was smaller than in the horses older than 3 years (P<0.05 among age groups). The 2-year-olds had larger CSA of the DDFTs than the 3-year-olds (P<0.01), and the CSA was also larger in the older horses of all breeds (P<0.01). However, the 3-year-old QH and SBs had smaller CSAs of the DDFT than the horses older than 3 years of age, (P<0.001), but interestingly the CSA was not different in the TB and WBs based on age (P≯0.05). The CSA of the AL-DDFT in the left forelimb was smaller than in the right forelimb (P<0.01) of all horses. The results of this study show that differential effects exist between age and within breeds on the CSA of the SDFT, DDFT and AL-DDFT, indicating that training and management may play a role, in addition to genetics, in the CSA of the metacarpal region flexor tendons of horses. The data on the CSAs of the SDFT, DDFT and AL-DDFT in WB, QH and SBs provides additional physiological references for these breeds to compliment the CSA data previously published for other breeds.

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

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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