Brockmann Knut, Becker Peter, Schreiber Gudrun, Neubert Karin, Brunner Edgar, Bönnemann Carsten
Department of Pediatrics and Pediatric Neurology, Georg August University, Göttingen, Germany.
Neuromuscul Disord. 2007 Jul;17(7):517-23. doi: 10.1016/j.nmd.2007.03.015. Epub 2007 May 29.
Muscle ultrasound is considered a useful noninvasive technique for visualizing normal and pathological skeletal muscle. We determined the accuracy of qualitative muscle ultrasound in the discrimination of normal muscle from myopathic, neurogenic, and unspecifically abnormal tissue changes in the evaluation of suspected NMD in childhood. Sensitivity and specificity of muscle ultrasound were assessed by comparing sonographic classification of muscle tissue changes in 134 children with definitive diagnosis as provided by muscle histology or mutation analysis performed subsequently to the sonography. We found a sensitivity of 81% and a specificity of 96% for detection of any abnormal muscle tissue alteration by ultrasound. For detection of neurogenic changes, sensitivity was 77% with even higher specificity (98%). Accuracy was slightly lower for myopathic changes (79%) and clearly lower for unspecific abnormal tissue alterations (70%). Accuracy of ultrasound was lower in younger children. High reliability of muscle sonography justifies a more widespread use of this method in evaluation of suspected NMD in childhood.
肌肉超声被认为是一种用于观察正常和病理性骨骼肌的有用的非侵入性技术。我们确定了在儿童疑似神经肌肉疾病（NMD）评估中，定性肌肉超声区分正常肌肉与肌病性、神经源性及非特异性异常组织改变的准确性。通过比较134名儿童的肌肉组织变化的超声分类与肌肉组织学或超声检查后进行的突变分析所提供的确切诊断，评估肌肉超声的敏感性和特异性。我们发现超声检测任何异常肌肉组织改变的敏感性为81%，特异性为96%。对于检测神经源性改变，敏感性为77%，特异性更高（98%）。肌病性改变的准确性略低（79%），非特异性异常组织改变的准确性明显更低（70%）。超声在年幼儿童中的准确性较低。肌肉超声的高可靠性证明了该方法在儿童疑似NMD评估中更广泛应用的合理性。
