Department of Radiology, Namwon Medical Center, Namwon-si, Jeollabuk-do, Korea.
Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 03080, Korea.
Sci Rep. 2022 Jan 10;12(1):463. doi: 10.1038/s41598-021-04492-1.
Various methods were suggested to measure skeletal muscle areas (SMAs) using chest low-dose computed tomography (chest LDCT) as a substitute for SMA at 3rd lumbar vertebra level (L3-SMA). In this study, four SMAs (L1-SMA, T12-erector spinae muscle areas, chest wall muscle area at carina level, pectoralis muscle area at aortic arch level) were segmented semi-automatically in 780 individuals taking concurrent chest and abdomen LDCT for healthcare screening. Four SMAs were compared to L3-SMA and annual changes were calculated from individuals with multiple examinations (n = 101). Skeletal muscle index (SMI; SMA/height) cut-off for sarcopenia was determined by lower 5th percentile of young individuals (age ≤ 40 years). L1-SMA showed the greatest correlation to L3-SMA (men, R = 0.7920; women, R = 0.7396), and the smallest annual changes (0.3300 ± 4.7365%) among four SMAs. L1-SMI cut-offs for determining sarcopenia were 39.2cm/m in men, and 27.5cm/m in women. Forty-six men (9.5%) and ten women (3.4%) were found to have sarcopenia using L1-SMI cut-offs. In conclusion, L1-SMA could be a reasonable substitute for L3-SMA in chest LDCT. Suggested L1-SMI cut-offs for sarcopenia were 39.2cm/m for men and 27.5cm/m for women in Asian.
多种方法被建议用于使用胸部低剂量计算机断层扫描（chest LDCT）来测量骨骼肌面积（SMAs），以替代第三腰椎水平（L3-SMA）的 SMA。在这项研究中，对 780 名同时接受胸部和腹部 LDCT 健康筛查的个体进行了半自动分割，获得了四个 SMA（L1-SMA、T12-竖脊肌面积、隆突水平胸壁肌肉面积、主动脉弓水平胸肌面积）。将这四个 SMA 与 L3-SMA 进行了比较，并计算了有多次检查个体的年度变化（n=101）。确定肌肉减少症的骨骼肌指数（SMI；SMA/身高）切点是通过年轻个体（年龄≤40 岁）的第 5 个百分位数确定的。L1-SMA 与 L3-SMA 的相关性最高（男性，R=0.7920；女性，R=0.7396），四个 SMA 中年度变化最小（0.3300±4.7365%）。确定肌肉减少症的 L1-SMI 切点为男性 39.2cm/m，女性 27.5cm/m。使用 L1-SMI 切点，46 名男性（9.5%）和 10 名女性（3.4%）被诊断为肌肉减少症。总之，在胸部 LDCT 中，L1-SMA 可以作为 L3-SMA 的合理替代。建议的亚洲男性和女性肌肉减少症的 L1-SMI 切点分别为 39.2cm/m 和 27.5cm/m。
