Department of Physical Medicine & Rehabilitation, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Muscle Nerve. 2019 Apr;59(4):478-481. doi: 10.1002/mus.26411. Epub 2019 Feb 17.
Inclusion body myositis (IBM) can have clinical and electrodiagnostic features similar to other neuromuscular diseases, making it a diagnostic challenge. This prospective study was designed to determine the accuracy of forearm ultrasound for IBM.
Sixty adults were recruited (15 with IBM, 15 with amyotrophic lateral sclerosis [ALS], 15 with other myopathies, and 15 healthy controls), and each underwent ultrasound of the bilateral forearms (imaging the flexor digitorum profundus and flexor carpi ulnaris muscles). Three clinicians with varying ultrasound expertise assigned a diagnosis of IBM, ALS, other myopathy, or control, based on images alone.
Intrarater reliability was moderately strong. Interrater reliability varied based on clinician experience. Sensitivity was 73.33% and 66.67% for the expert raters. Specificity was strong for all 3 clinicians (93.33%, 84.44%, and 91.11%).
Neuromuscular ultrasound of the forearm is reliable and accurate for the diagnosis of IBM, although sensitivity was higher among experienced clinicians. Muscle Nerve 59:478-481, 2019.
包涵体肌炎（IBM）的临床表现和电诊断特征可能与其他神经肌肉疾病相似，这使其诊断具有挑战性。本前瞻性研究旨在确定前臂超声检查对 IBM 的准确性。
共招募了 60 名成年人（15 名 IBM 患者、15 名肌萎缩侧索硬化症[ALS]患者、15 名其他肌病患者和 15 名健康对照者），并对他们的双侧前臂进行超声检查（检查指深屈肌和尺侧腕屈肌）。三位具有不同超声专业知识的临床医生仅根据图像对 IBM、ALS、其他肌病或对照组进行诊断。
组内观察者间的可靠性为中度强。观察者间的可靠性因临床医生的经验而异。两位专家观察者的敏感性分别为 73.33%和 66.67%。所有 3 位临床医生的特异性均较强（93.33%、84.44%和 91.11%）。
前臂的神经肌肉超声检查对于 IBM 的诊断是可靠且准确的，尽管经验丰富的临床医生的敏感性更高。肌肉神经 59：478-481，2019 年。
