Department of Neurology, RWTH Aachen University, Pauwels Street 30, 52074 Aachen, Germany.
Faculty of Medicine, Cairo University, 1 Gamaa Street, Cairo 12613, Egypt.
Cells. 2022 Feb 9;11(4):600. doi: 10.3390/cells11040600.
Inclusion body myositis (IBM) is a slowly progressive muscle weakness of distal and proximal muscles, which is diagnosed by clinical and histopathological criteria. Imaging biomarkers are inconsistently used and do not follow international standardized criteria. We conducted a systematic review and meta-analysis to investigate the diagnostic value of muscle ultrasound (US) in IBM compared to healthy controls. A systematic search of PubMed/MEDLINE, Scopus and Web of Science was performed. Articles reporting the use of muscle ultrasound in IBM, and published in peer-reviewed journals until 11 September 2021, were included in our study. Seven studies were included, with a total of 108 IBM and 171 healthy controls. Echogenicity between IBM and healthy controls, which was assessed by three studies, demonstrated a significant mean difference in the flexor digitorum profundus (FDP) muscle, which had a grey scale value (GSV) of 36.55 (95% CI, 28.65-44.45, < 0.001), and in the gastrocnemius (GC), which had a GSV of 27.90 (95% CI 16.32-39.48, < 0.001). Muscle thickness in the FDP showed no significant difference between the groups. The pooled sensitivity and specificity of US in the differentiation between IBM and the controls were 82% and 98%, respectively, and the area under the curve was 0.612. IBM is a rare disease, which is reflected in the low numbers of patients included in each of the studies and thus there was high heterogeneity in the results. Nevertheless, the selected studies conclusively demonstrated significant differences in echogenicity of the FDP and GC in IBM, compared to controls. Further high-quality studies, using standardized operating procedures, are needed to implement muscle ultrasound in the diagnostic criteria.
包涵体肌炎（IBM）是一种进行性缓慢的四肢近端和远端肌肉无力，其诊断标准是临床和组织病理学标准。成像生物标志物的应用并不一致，也不符合国际标准化标准。我们进行了一项系统评价和荟萃分析，以调查肌肉超声（US）在 IBM 中的诊断价值，与健康对照组进行比较。对 PubMed/MEDLINE、Scopus 和 Web of Science 进行了系统搜索。我们的研究纳入了在同行评审期刊上发表的报告 IBM 中使用肌肉超声的文章，截至 2021 年 9 月 11 日。共纳入了 7 项研究，其中包括 108 例 IBM 和 171 例健康对照组。有 3 项研究评估了 IBM 和健康对照组之间的肌肉回声，结果显示，指深屈肌（FDP）的灰度值（GSV）有显著差异，其 GSV 值为 36.55（95%CI，28.65-44.45，<0.001），腓肠肌（GC）的 GSV 值为 27.90（95%CI，16.32-39.48，<0.001）。FDP 中的肌肉厚度在两组间无显著差异。US 在 IBM 与对照组之间的鉴别中，其汇总敏感性和特异性分别为 82%和 98%，曲线下面积为 0.612。IBM 是一种罕见疾病，这反映在每项研究中纳入的患者数量较少，因此结果存在高度异质性。尽管如此，所选研究确实证明了 IBM 中 FDP 和 GC 的回声强度与对照组相比存在显著差异。需要进一步开展高质量的研究，使用标准化的操作程序，将肌肉超声纳入诊断标准中。
