Department of Traumatology, Maastricht University Medical Centre+, 6229 HX Maastricht, the Netherlands.; Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, the Netherlands.
Department of Traumatology, Maastricht University Medical Centre+, 6229 HX Maastricht, the Netherlands.; Department of Surgery, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, 6229 HX Maastricht, the Netherlands.
Injury. 2022 Nov;53 Suppl 3:S23-S29. doi: 10.1016/j.injury.2022.06.004. Epub 2022 Jun 15.
BACKGROUND & AIM: Sarcopenia is defined as a loss of muscle mass and function, which can be caused by normal ageing or factors such as physical inactivity. Severe health consequences caused by sarcopenia highlight the need for early identification. Computed Tomography (CT) imaging, often mentioned as the gold standard due to its accuracy, is costly and not routinely performed in daily clinical care. Ultrasound of the rectus femoris, however, is low in costs and easily accessible. The aim is to present the current and most recent literature regarding the diagnostic value of ultrasound measurements of the rectus femoris for the diagnosis of sarcopenia in adults.
The databases PubMed and Web of Science were used to search for studies comparing ultrasound of the rectus femoris with a reference test to diagnose sarcopenia in adults. The quality of the final eligible studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies, version 2, tool (QUADAS-2).
Six studies were included in this systematic review. The muscle thickness and cross-sectional area of the rectus femoris were assessed and compared with the reference tests CT, Dual-Energy X-ray Absorptiometry (DXA), and Bioelectrical Impedance Analysis (BIA). Half of the studies had a low risk of bias on all QUADAS-2 domains. Three studies reported statistical significant outcomes and diagnostic values ranging from 60 to 81% sensitivity and 51 to 94% specificity.
Ultrasound of the rectus femoris muscle to diagnose sarcopenia has been shown to be a promising method in multiple clinical populations. However, there were some limitations such as a high methodological heterogeneity. Future research should develop standardized protocols and determine clear cut-off values to allow for a better implementation of ultrasound in clinical practice.
肌少症是指肌肉质量和功能的丧失，可由正常衰老或身体活动不足等因素引起。肌少症导致的严重健康后果凸显出早期识别的必要性。计算机断层扫描（CT）成像因准确性常被认为是金标准，但成本高，在日常临床护理中不常规进行。然而，股直肌超声检查成本低，易于获得。目的是介绍目前关于股直肌超声测量诊断成年人肌少症的诊断价值的最新文献。
使用 PubMed 和 Web of Science 数据库搜索比较股直肌超声与参考测试以诊断成年人肌少症的研究。使用 QUADAS-2 工具（质量评估诊断准确性研究，版本 2）评估最终合格研究的质量。
本系统评价纳入了 6 项研究。评估并比较了股直肌的肌肉厚度和横截面积与 CT、双能 X 射线吸收法（DXA）和生物电阻抗分析（BIA）等参考测试。一半的研究在 QUADAS-2 的所有领域均具有低偏倚风险。有 3 项研究报告了具有统计学意义的结果和诊断价值，敏感性为 60%至 81%，特异性为 51%至 94%。
股直肌超声诊断肌少症已在多种临床人群中显示出良好的应用前景。然而，还存在一些局限性，例如方法学异质性较高。未来的研究应制定标准化方案并确定明确的截断值，以促进超声在临床实践中的更好应用。
