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Quantitative ultrasonography of skeletal muscles in children: normal values
R R Scholten1, S Pillen, A Verrips
1Department of Paediatric Neurology, Neuromuscular Center Nijmegen, Institute of Neurology, University Medical Center, Nijmegen, The Netherlands.
Insights
This study establishes normal ultrasound values for pediatric muscle thickness and fat ratios, finding weight impacts thickness and age impacts the thickness-to-fat ratio. These findings aid in diagnosing neuromuscular diseases in children.
Area of Science:
- Pediatric Musculoskeletal Ultrasound
- Biomedical Engineering
- Diagnostic Imaging
Background:
- Establishing normative data for pediatric musculoskeletal ultrasound parameters is crucial for accurate diagnosis.
- Previous research has not comprehensively defined normal values for muscle thickness, fat ratios, and echo intensity across a wide pediatric age range.
Purpose of the Study:
- To establish normal reference values for muscle thickness, muscle-to-subcutaneous fat thickness ratio, and muscle echo intensity in children aged 11 weeks to 16 years.
- To identify key demographic factors (age, height, weight, sex) influencing these ultrasound parameters.
- To provide equations for calculating normal values to aid in clinical diagnosis.
Main Methods:
- Standardized real-time ultrasound examinations were performed on four muscles in pediatric subjects.
- Digitization of ultrasound scans allowed for gray-scale analysis to measure mean echo intensity.
- Multiple regression analysis was employed to determine the influence of age, height, weight, and sex on the measured parameters.
Main Results:
- Pediatric muscle thickness was significantly correlated with body weight.
- The ratio of muscle thickness to subcutaneous fat thickness demonstrated a significant dependence on age.
- Muscle echo intensity showed no significant correlation with age, height, weight, or sex.
- Normal values and predictive equations for each parameter were established.
Conclusions:
- This study provides essential normative ultrasound data for pediatric muscle and fat measurements.
- The established reference ranges and equations can enhance the diagnostic utility of ultrasound in pediatric neuromuscular disease evaluation.
- Weight and age are key determinants of muscle thickness and fat ratios, respectively, in children.
Abstract:
The purpose of this study was to establish normal values of muscle thickness, ratio of muscle thickness to subcutaneous fat thickness, and muscle echo intensity in children between 11 weeks and 16 years of age. Transverse scans of four muscles were made by standardized real-time ultrasound examination. The scans were digitized, and mean echo intensity was measured using gray-scale analysis. A multiple regression equation was used to study which independent parameter (age, height, weight, or sex) influenced the variables for each muscle. Muscle thickness depended on the child's weight. The other parameters did not significantly influence muscle thickness after correction for weight. The ratio of muscle thickness to subcutaneous fat thickness depended on age. Echo intensity showed no correlation with either of the variables. As a result, all normal values, including the equation to calculate them, are described. These normal data may help to determine the diagnostic value of muscle ultrasound in children with suspected neuromuscular disease.