BackgroundSarcopenia is a devastating disease for older adults, but it lacks accessible and reliable tools for measuring total appendicular skeletal muscle mass (ASMM). Two‐dimensional muscle ultrasound (US) has been developed for its bedside clinical advantages and feasibility but lacks standardization and prediction performance. We previously validated a new 3D‐US technique to measure muscle volume (MV) at bedside and applied it in a geriatric rehabilitation setting.Objectives were to analyse the concordance between 3D‐US MV and ASMM and compare concordance between 3D‐US MV and 2D‐US parameters with ASMM.MethodsParticipants were recruited in a Geriatric rehabilitation ward in Nantes, France, from May to October 2022. Exclusion criteria were as follows: oedema in the lower limbs or recent history of unilateral lower limb damage or stroke. ASMM was measured with bioelectrical impedance analysis; 3D‐US and 2D‐US acquisitions were performed on three muscles of the right lower limb. Measures of strength (hand grip, knee extension and ankle dorsiflexion) were also recorded. Reliability of 3D‐US MV measurements on 10 participants was high (ICC = 0.99).We used Lin's concordance correlation coefficients (CCC) and bias correction factor for agreement between variables and linear regression models for prediction equations.ResultsFifty‐eight participants had an interpretable ASMM of whom 17 (29%) had a diagnosis of sarcopenia. Volumes of TA, RF and VL were all significantly concordant with ASMM measured by BIA (all p values < 0.001), with CCCs respectively of 0.72, 0.61 and 0.60. MV were all significantly concordant with isometric strength (p values < 0.001). Concordance and correlation with ASMM were higher with 3D‐US than 2D‐US measurements regardless of the muscle. Prediction of ASMM reached an adjusted R2 of 0.8 with tibialis anterior volume, biometrics and 2D measurements.ConclusionsThis study was the first to use 3D‐US in a geriatric setting and develop a model to predict ASMM in very old hospitalized patients. MV measurements with 3D‐US proved to be reliable and more concordant with appendicular muscle mass and strength than 2D parameters.

中文翻译：

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老年康复病房徒手 3D 超声肌肉测量值与肌肉减少症参数的一致性


背景肌肉减少症对老年人来说是一种毁灭性的疾病，但它缺乏测量总附肢骨骼肌质量 （ASMM） 的可及且可靠的工具。二维肌肉超声 （US） 因其床旁临床优势和可行性而开发，但缺乏标准化和预测性能。我们之前验证了一种新的 3D-US 技术来测量床边肌肉体积 （MV），并将其应用于老年康复环境。目的是分析 3D-US MV 和 ASMM 之间的一致性，并将 3D-US MV 和 2D-US 参数与 ASMM 之间的一致性进行比较。方法参与者于 2022 年 5 月至 2022 年 10 月在法国南特的老年康复病房招募。排除标准如下： 下肢水肿或近期单侧下肢损伤或中风病史。ASMM 采用生物电阻抗分析测量;对右下肢的三块肌肉进行 3D-US 和 2D-US 采集。还记录了力量测量 （握力、膝关节伸展和踝关节背屈）。10 名参与者的 3D-US MV 测量的可靠性很高 （ICC = 0.99）。我们使用 Lin's 一致性相关系数 （CCC） 和偏差校正因子来计算变量之间的一致性，并使用线性回归模型进行预测方程。结果58 名参与者患有可解释的 ASMM，其中 17 名 （29%） 诊断为肌肉减少症。TA 、 RF 和 VL 的体积均与 BIA 测量的 ASMM 显著一致 （均 p 值 < 0.001），CCCs 分别为 0.72 、 0.61 和 0.60。MV 均与等长强度显著一致 （p 值 < 0.001）。无论肌肉如何，3D-US 测量与 ASMM 的一致性和相关性都高于 2D-US。 ASMM 的预测达到 0.8 的调整后 R2 胫骨前体积、生物识别和 2D 测量。结论本研究首次在老年病学环境中使用 3D-US，并开发了一个模型来预测非常老年住院患者的 ASMM。事实证明，使用 3D-US 进行的 MV 测量是可靠的，并且比 2D 参数更符合四肢肌肉质量和力量。