Echo intensity as an indicator of skeletal muscle quality: applications, methodology, and future directions

Stock, Matt S.; Thompson, Brennan J.

doi:10.1007/s00421-020-04556-6

Cited by 97 publications

(122 citation statements)

References 94 publications

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“…Low echo intensity values are considered to be associated with greater muscle quality; in contrast, high echo intensity values are thought to be related to muscle impairment [33]. US has been shown to be a reliable tool for the assessment of muscle quality as echo intensity in different populations [33], including young athletes [36]. Echo intensity has been mainly used to study muscle quality changes in aging [34], although attempts to apply it in a sports setting have been conducted [37][38][39].…”

Section: Muscle Qualitymentioning

confidence: 99%

“…In addition to measures of muscle morphology, estimation of muscle quality (based on tissue composition) can also be obtained by quantitative musculoskeletal US [ 33 ]. Echo intensity (or “echogenicity”) is the measure of the reflectivity of sound waves reflected by the tissue.…”

Section: Practical Aspectsmentioning

confidence: 99%

“…Echo intensity (or “echogenicity”) is the measure of the reflectivity of sound waves reflected by the tissue. Echogenicity is considered a proxy of muscle composition and in turn it may be used as an index of muscle quality [ 33 , 34 ]. Connective tissue and fat are more reflective than muscle tissue and thus appear in the image as lighter grey.…”

Section: Practical Aspectsmentioning

confidence: 99%

“…The largest region of interest excluding aponeuroses is generally detected and then echo intensity measures are calculated as median grayscale values (a 0–255 scale of arbitrary units, with a higher value indicating more hyperechoic material) using programs such as ImageJ or Photoshop [ 35 ]. Low echo intensity values are considered to be associated with greater muscle quality; in contrast, high echo intensity values are thought to be related to muscle impairment [ 33 ]. US has been shown to be a reliable tool for the assessment of muscle quality as echo intensity in different populations [ 33 ], including young athletes [ 36 ].…”

Section: Practical Aspectsmentioning

confidence: 99%

“…While some reports support the use of echo intensity as a marker for muscle quality in different interventions [ 143 , 144 ], in our experience echo intensity measures do not show great sensitivity for changes in muscle quality after training or unloading periods in young subjects (unpublished data). In support of this notion, echo intensity response to chronic exercise training is controversial in young subjects, while decreases in echo intensity seem to be consistent in older adults [ 33 ]. Moreover, echo intensity has been shown to change at the presentation of a serious injury (Achilles tendon rupture), but was not different when compared to the contralateral muscle after 2 and 4 week post-injury [ 140 ].…”

Section: General Issuesmentioning

confidence: 99%

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Implementing Ultrasound Imaging for the Assessment of Muscle and Tendon Properties in Elite Sports: Practical Aspects, Methodological Considerations and Future Directions

et al. 2021

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Ultrasound (US) imaging has been widely used in both research and clinical settings to evaluate the morphological and mechanical properties of muscle and tendon. In elite sports scenarios, a regular assessment of such properties has great potential, namely for testing the response to training, detecting athletes at higher risks of injury, screening athletes for structural abnormalities related to current or future musculoskeletal complaints, and monitoring their return to sport after a musculoskeletal injury. However, several practical and methodological aspects of US techniques should be considered when applying this technology in the elite sports context. Therefore, this narrative review aims to (1) present the principal US measures and field of applications in the context of elite sports; (2) to discuss, from a methodological perspective, the strengths and shortcomings of US imaging for the assessment of muscle and tendon properties; and (3) to provide future directions for research and application.

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Section: Muscle Qualitymentioning

confidence: 99%

Section: Practical Aspectsmentioning

confidence: 99%

Section: Practical Aspectsmentioning

confidence: 99%

Section: Practical Aspectsmentioning

confidence: 99%

Section: General Issuesmentioning

confidence: 99%

See 3 more Smart Citations

Implementing Ultrasound Imaging for the Assessment of Muscle and Tendon Properties in Elite Sports: Practical Aspects, Methodological Considerations and Future Directions

et al. 2021

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Compensation strategy of shoulder synergist muscles is not stereotypical in patients with rotator cuff repair

Umehara

Yagi

Ueda

et al. 2023

Journal Orthopaedic Research

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Rotator cuff tear is a common shoulder injury that causes shoulder dysfunction and pain. Although surgical repair is the primary treatment for rotator cuff tear, it is well recognized that impaired force exertion of muscles connecting to the involved tendon and subsequent complemental change in the force exertion of synergist muscles persist even after repair. This study aimed to identify the compensation strategy of shoulder abductors by examining how synergist muscles respond to supraspinatus (SSP) muscle force deficit in patients with rotator cuff repair. Muscle shear modulus, an index of muscle force, was assessed for SSP, infraspinatus, upper trapezius, and middle deltoid muscles in repaired and contralateral control shoulders of 15 patients with unilateral tendon repair of the SSP muscle using ultrasound shear wave elastography while the patients passively or actively held their arm in shoulder abduction. In the repaired shoulder, the shear modulus of the SSP muscle declined, whereas that of other synergist muscles did not differ relative to that of the control. To find the association between the affected SSP and each of the synergist muscles, a regression analysis was used to assess the shear moduli at the population level. However, no association was observed between them. At the individual level, there was a tendency of variation among patients with regard to a specific muscle whose shear modulus complementarily increased. These results suggest that the compensation strategy for SSP muscle force deficit varies among individuals, being nonstereotypical in patients with rotator cuff injury.

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Femoral cartilage ultrasound echo‐intensity is a valid measure of cartilage composition

Harkey,

Michel,

Grozier

et al. 2023

Journal Orthopaedic Research

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This study aimed to create a conversion equation that accurately predicts cartilage magnetic resonance imaging (MRI) T2 relaxation times using ultrasound echo‐intensity and common participant demographics. We recruited 15 participants with a primary anterior cruciate ligament reconstruction between the ages of 18‐35 years at 1‐5 years after surgery. A single investigator completed a transverse suprapatellar scan with the ACLR limb in max knee flexion to image the femoral trochlea cartilage. A single reader manually segmented the femoral cartilage cross‐sectional area to assess the echo‐intensity (i.e., mean grey‐scale pixel value). At a separate visit, a T2 mapping sequence with the MRI beam set to an oblique angle was used to image the femoral trochlea cartilage. A single reader manually segmented the cartilage cross‐sectional area on a single MRI slice to assess the T2 relaxation time. A stepwise, multiple linear regression was used to predict T2 relaxation time from cartilage echo‐intensity and common demographic variables. We created a conversion equation using the regression betas and then used an ICC and Bland‐Altman plot to assess agreement between the estimated and true T2 relaxation time. Cartilage ultrasound echo‐intensity and age significantly predicted T2 relaxation time (F=7.33, p=0.008, R2=0.55). When using the new conversion equation to estimate T2 relaxation time from cartilage echo‐intensity and age, there was strong agreement between the estimated and true T2 relaxation time (ICC2,k=0.84). This study provides promising preliminary data that cartilage echo‐intensity combined with age can be used as a clinically accessible tool for evaluating cartilage composition.This article is protected by copyright. All rights reserved.

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Echo intensity as an indicator of skeletal muscle quality: applications, methodology, and future directions

Cited by 97 publications

References 94 publications

Implementing Ultrasound Imaging for the Assessment of Muscle and Tendon Properties in Elite Sports: Practical Aspects, Methodological Considerations and Future Directions

Implementing Ultrasound Imaging for the Assessment of Muscle and Tendon Properties in Elite Sports: Practical Aspects, Methodological Considerations and Future Directions

Compensation strategy of shoulder synergist muscles is not stereotypical in patients with rotator cuff repair

Femoral cartilage ultrasound echo‐intensity is a valid measure of cartilage composition

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