Department of Health, Sport, and Exercise Sciences, University of Kansas Edwards Campus, Overland Park, Kansas, United States of America.
Department of Geriatric Medicine, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, United States of America.
PLoS One. 2022 May 2;17(5):e0267641. doi: 10.1371/journal.pone.0267641. eCollection 2022.
Ultrasound devices are common in muscle physiology laboratories due to their ease of use and validity to assess skeletal muscle characteristics. The current study assessed the reliability of ultrasound skeletal muscle image analysis across multiple raters with limited experience. Vastus lateralis (VL), rectus femoris (RF), and first dorsal interosseus (FDI) images were separately analyzed by three novice raters to determine muscle thickness (MT), cross-sectional area (CSA), and echo-intensity (EI). Separate analyses of variance (ANOVA) assessed statistical differences between and within raters. Intra-class correlation coefficients (ICC) between (inter-rater) and within (intra-rater) raters, the standard error of the measurement (SEM) and minimal difference needed to be considered real were calculated. Inter-rater reliability was high for the VL and RF (ICC: 0.984-0.999), while the FDI was lower (0.614-0.962). Further, intra-rater reliability was greater than 0.961 for each rater. SEM values calculated for inter-rater reliability expressed as a percentage of the mean ranged from 0.4-5.8% across variables. Similarly, SEM values for intra-rater reliability were between 0.8-5.8%, 0.6-3.6%, and 0.4-3.2% for Raters 1, 2 and 3, respectively. Despite this, significant differences (p<0.05) between raters were observed for RF MT and EI, VL CSA and EI, and FDI MT, suggesting that potentially more measurement trials or greater practice time may be necessary to reduce systematic error among multiple raters. Post-image acquisition processing is reliable among and within raters as determined through ICCs and SEMs. This study provided consistent results among three separate novice raters given the same training, a unique yet realistic setting in muscle physiology laboratories.
由于超声设备易于使用且可用于评估骨骼肌特征，因此在肌肉生理学实验室中很常见。本研究评估了具有有限经验的多个评估者对超声骨骼肌图像分析的可靠性。三名新手评估者分别分析了股外侧肌（VL）、股直肌（RF）和第一骨间背侧肌（FDI）的图像，以确定肌肉厚度（MT）、横截面积（CSA）和回波强度（EI）。单独的方差分析（ANOVA）评估了评估者之间和评估者内部的统计差异。计算了评估者之间（组内）和评估者内部（组内）的组内相关系数（ICC）、测量标准误差（SEM）和认为有意义的最小差异。VL 和 RF 的组间可靠性较高（ICC：0.984-0.999），而 FDI 的可靠性较低（0.614-0.962）。此外，每位评估者的组内可靠性均大于 0.961。以平均值的百分比表示的组间可靠性的 SEM 值在变量之间的范围为 0.4-5.8%。同样，1、2 和 3 号评估者的组内可靠性的 SEM 值分别为 0.8-5.8%、0.6-3.6%和 0.4-3.2%。尽管如此，仍观察到 RF MT 和 EI、VL CSA 和 EI 以及 FDI MT 之间的评估者之间存在显著差异（p<0.05），这表明可能需要更多的测量试验或更多的实践时间来减少多个评估者之间的系统误差。通过 ICC 和 SEM 确定，图像采集后处理在评估者之间和内部是可靠的。本研究在肌肉生理学实验室中提供了在相同培训下三个不同新手评估者的一致结果，这是一个独特但现实的设置。
