Waduud Mohammed Abdul, Adusumilli Pratik, Drozd Michael, Bailey Marc A, Cuthbert Gary, Hammond Christopher, Scott Julian A
1 Leeds Vascular Institute, Leeds General Infirmary , Leeds , UK.
2 Department of Radiology, Leeds General Infirmary , Leeds , UK.
Br J Radiol. 2019 May;92(1097):20180434. doi: 10.1259/bjr.20180434. Epub 2019 Apr 9.
We investigated whether total psoas muscle area (TPMA) was representative of the total psoas muscle volume (TPMV). Secondly, we assessed whether there was a relationship between the two commonly used single slice measurements of sarcopenia, TPMA and total abdominal muscle area (TAMA).
Pre-operative CT imaging of 110 patients undergoing elective endovascular aneurysm repair were analyzed by two trained independent observers. TPMA was measured at individual vertebral levels between the second lumbar vertebrae and sacrum. TPMV was also estimated between the second lumbar vertebrae and sacrum. TAMA was measured at the third lumbar vertebrae (L3). Observer differences were assessed using Bland-Altman plots. Associations between the different measures were assessed using linear regression and Pearson's correlation.
We found single slice measurements of the TPMA to be representative of the TPMV at individual levels between L2 to the sacrum. The strongest association was seen at L3 [adjusted regression coefficient 16.7, 95% confidence interval (12.1 to 21.4), < 0.001]. There was no association between TPMA and TAMA [adjusted regression coefficient -0.7, 95% confidence interval (-4.1 to 2.8), = 0.710].
We demonstrate that measurements of the TPMA between L2 to the sacrum are representative of the TPMV, with the greatest association at the third lumbar vertebrae. There was no association between the TPMA and TAMA.
We demonstrate that a single slice measurement of TPMA at L3 is representative of the muscle volume, contrary to previous criticism. Future sarcopenia studies can continue to measure TPMA which is representative of the TPMV.
我们研究了腰大肌总面积(TPMA)是否能代表腰大肌总体积(TPMV)。其次,我们评估了常用于诊断肌肉减少症的两个单层面测量指标,即TPMA和腹直肌总面积(TAMA)之间是否存在关联。
由两名经过培训的独立观察者对110例行择期血管内动脉瘤修复术患者的术前CT影像进行分析。在第二腰椎至骶骨之间的各个椎体水平测量TPMA。同时也在第二腰椎至骶骨之间估算TPMV。在第三腰椎(L3)水平测量TAMA。使用Bland-Altman图评估观察者之间的差异。使用线性回归和Pearson相关性评估不同测量指标之间的关联。
我们发现,在L2至骶骨之间的各个水平,TPMA的单层面测量值能够代表TPMV。在L3水平观察到最强的关联[校正回归系数16.7,95%置信区间(12.1至21.4),P<0.001]。TPMA与TAMA之间无关联[校正回归系数-0.7,95%置信区间(-4.1至2.8),P=0.710]。
我们证明,L2至骶骨之间的TPMA测量值能够代表TPMV,在第三腰椎水平的关联最强。TPMA与TAMA之间无关联。
我们证明,与之前的批评观点相反,L3水平的TPMA单层面测量值能够代表肌肉体积。未来关于肌肉减少症的研究可以继续测量能够代表TPMV的TPMA。