Volume estimation of extensor muscles of the lower leg based on MR imaging

Magnetic resonance imaging can be used to measure the muscle volume of a given muscle or muscle group. The purpose of this study was to determine both the intra- and inter-observer variation of the manually outlined volume of the extensor muscles (tibialis anterior, extensor digitorum longus and extensor hallucis longus), to estimate the minimum number of slices needed for these calculations and to compare estimates of volume based on an assumed conic shape of the muscles with that of an assumed cylindrical shape, the calculation in both cases based on the Cavalieri principle. Eleven young and healthy subjects (4 women and 7 men, age range 24-40 years) participated. Magnetic resonance imaging of the left leg was obtained on a 1.5-T MR system using a knee coil (receive only). A total of 50 consecutive slices were obtained beginning 10 cm below the caput fibula sin. and proceeding distally with a slice thickness of 1.5 mm without gap. The intra-class correlation coefficient (ICC) was used to calculate the relative reliability (interval from 0 to 1.0). A high reliability for both intra- and inter-reliability was observed (ICC 0.98 and 1.0). The difference was only 0.004% between calculations based on measurement of all 50 slices with respect to 8 slices equally distributed along the muscle group. No difference was found between the two different volumetric assumptions in the Cavalieri principle. The manually outlining of extensor muscles volumes was reliable and only 8 slices of the calf were needed. No difference was seen between the two used mathematical calculations.