A comparison of 3D ultrasound to MRI for the measurement and estimation of gastrocnemius muscle volume in adults and young people with and without cerebral palsy

Abstract

Muscle volume (MV) is an important parameter for understanding muscle morphology and adaptations to training, growth and pathology. In this study, we assessed the validity of freehand 3D ultrasound (3DUS) for measuring medial gastrocnemius MV in adults, typically developing (TD) children and children with cerebral palsy (CP). We also assessed the validity between our direct measures of MV and estimates derived from anatomical cross sectional area (ACSA) and muscle length (ML), using previously outlined methods. The medial gastrocnemius of all groups was scanned with 3DUS and MRI. Images from both methods were digitized to derive MV, ACSA and ML. Measured MV was compared between methods and compared to estimated MV derived from recently published algorithms. MV had a mean difference of −0.13% (standard error of estimate (SEE) = 2.23%, R 2 = 0.99) between MRI and 3DUS and 19.82% (SEE = 4.73% and R 2 = 0.99) and −3.11% (SEE = 6.55%, R 2 = 0.99) mean differences between the measured and estimated MV from two methods of estimation. The 3DUS is a valid method for the measurement of MV in adults, TD children and those with CP. Estimation methods of MV may be useful in clinical practice, but require further replication on various populations and careful methodological consideration.

Measuring skeletal muscle morphology and architecture with imaging modalities in children with cerebral palsy: a scoping review

“…Studies were categorized as observational ( n =45 cross‐sectional, 28–31,33–59,83–90,94,95,97,98,105,106 and n =1 longitudinal), 32 experimental ( n =25), 60–78,91,92,99–101,107 or methodology studies ( n =9) 79–82,93,96,102–104 (Table S2). Of the 25 intervention studies, 60–78,91,92,99–101,107 21 studies used musculoskeletal imaging as an outcome measure after a single intervention: botulinum neurotoxin‐A (BoNT‐A) ( n =6), 76,78,91,99,101,107 strength training ( n =3), 62,71,73 neuromuscular electrical stimulation ( n =3), 63,77,92 surgery ( n =2), 60,72 stretching ( n =2), 45,61 gait training (walk‐run) ( n =1), 65 vibration training ( n =1), 64 an aquatic programme ( n =1), 68 ankle bracing ( n =1), 66 and balance training ( n =1) 100 .…”

“…Three studies 67,74,75 used musculoskeletal imaging as an outcome measure after a combination of interventions – BoNT‐A plus strength training (compared to a BoNT‐A control period), 75 functional training plus neurodevelopmental treatment (compared to neurodevelopmental treatment group), 67 and neuromuscular electrical stimulation plus strength training (compared to a strength training only group) 74 – and one study compared outcomes of a stretching intervention with treadmill training 69 . Nine studies focused on methodological aspects of musculoskeletal imaging as a measurement tool in CP muscle 79–82,93,96,102–104 …”

“…The muscle variables assessed within the studies reviewed were dependent on the imaging methodology. The two most commonly assessed variables were fascicle length ( n =35) 28–30,33–43,45–47,60–62,66,68–71,79,84,85,87,88,91,92,99,101,105 (measured via ultrasound), and muscle volume ( n =35) 49–51,53–59,72,73,75–78,80–82,84,87–90,93–99,103–105,107 (measured using MRI, 3DUS, and 2DUS estimation methods) 81,93,96 . Muscle thickness ( n =30) 28,29,31–36,38,41,42,46,62–64,66–69,71,83–86,91,100–102,106 and pennation angle (alternately referred to as fascicle angle) ( n =29) 28–30,33–38,42,46,60–63,66–71,79,84,85,88,91,92,99,101 were assessed via (2D) ultrasound methods.…”

Progressive resistance training for adolescents with cerebral palsy: the STAR randomized controlled trial

“…The following outcomes were assessed on the participant’s affected leg in the case of unilateral CP, the most affected leg in the case of bilateral CP, or the right leg if a participant reported that both sides were equally affected. Achilles tendon cross‐sectional area and medial gastrocnemius muscle volume were assessed using a three‐dimensional freehand ultrasonography method 22 . Change in medial gastrocnemius muscle length was measured with a combination of 3D motion analysis and 2D ultrasound 14 .…”

Concentric versus eccentric training: Effect on muscle strength, regional morphology, and architecture

“…All morphological (muscle volume and anatomical cross‐sectional area) and architectural measures (fascicle length and fascicle angle) were taken on the VL muscle and measured using a 3D ultrasound method, 30 Macgillivray et al 31 . For this method, a rigid body of four markers is secured to the handle of an ultrasound probe.…”