Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China.
West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.
J Ultrasound Med. 2021 Aug;40(8):1637-1648. doi: 10.1002/jum.15552. Epub 2020 Nov 20.
This original research aimed to investigate the value of ultrasound (US), including grayscale US and shear wave elastography (SWE), in quantitatively evaluating muscle mass after kidney transplantation.
A total of 52 patients and 54 healthy control participants were recruited. High-frequency US was used to evaluate the echo intensity and muscle morphologic features. Muscle stiffness in the rectus femoris was assessed with SWE. Interclass and intraclass correlation coefficients were used for evaluating measurement reliability. The diagnostic performance of SWE was determined by a receiver operating characteristic curve analysis.
The intraobserver and interobserver repeatability was excellent (all correlation coefficients >0.940; P < .05). The best evaluation point after right iliac fossa transplantation was at the lower third of the right leg. In patients, the skin (0.154 versus 0.192 cm) and rectus femoris (0.700 versus 0.905 cm) were thinner, and the pinnate angle (6.500° versus 8.000°) and area (0.965 versus 1.270 cm ) were smaller (all P < .05). The US results showed that, compared with the controls, all patients' rectus femoris echo intensity (P < .001 in the transverse section) and elastic modulus (P < .001 in the Young modulus and shear wave speed) increased significantly. The cutoff values were 10.05 and 10.37, and the areas under the receiver operating characteristic curves were 0.843 and 0.845 for predicting kidney transplant and sarcopenia, respectively.
This noninvasive and convenient technique might be effective for objectively evaluating the muscle mass of patients after kidney transplantation.
本研究旨在探讨超声（包括灰阶超声和剪切波弹性成像）定量评估肾移植后肌肉量的价值。
共纳入 52 例患者和 54 例健康对照者。高频超声用于评估回声强度和肌肉形态特征。剪切波弹性成像评估股直肌硬度。采用组内相关系数和组间相关系数评估测量的可靠性。采用受试者工作特征曲线分析评估剪切波弹性成像的诊断性能。
观察者内和观察者间的重复性均极好（所有相关系数>0.940；P<0.05）。右髂窝移植后最佳评估点位于小腿中下 1/3 处。与对照组相比，患者的皮肤（0.154cm 比 0.192cm）和股直肌（0.700cm 比 0.905cm）更薄，羽状角（6.500°比 8.000°）和面积（0.965cm 比 1.270cm）更小（均 P<0.05）。超声结果显示，与对照组相比，所有患者的股直肌回声强度（横断位 P<0.001）和杨氏模量（P<0.001）均显著增加。截断值分别为 10.05 和 10.37，预测肾移植和肌少症的受试者工作特征曲线下面积分别为 0.843 和 0.845。
该非侵入性和方便的技术可能对客观评估肾移植后患者的肌肉量有效。
