Validity of Ultrasound Imaging in Measuring Quadriceps Muscle Thickness and Cross-Sectional Area in Patients Receiving Maintenance Hemodialysis

Sahathevan S 1 , Khor BH 2 , Yeong CH 3 , Tan TH 4 , Meera Mohaideen AK 3 , Ng HM 3 Show all authors , Ong GR 5 , Narayanan SS 5 , Abdul Gafor AH 2 , Goh BL 6 , Bee BC 7 , Mat Daud Z' 8 , Chinna K 3 , Karupaiah T 5

Affiliations 

  • 1 Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • 2 Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • 3 School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, Selangor, Malaysia
  • 4 Nuclear Medicine Centre, Sunway Medical Centre, Selangor, Malaysia
  • 5 School of BioSciences, Faculty of Health & Medical Sciences, Taylor's University, Selangor, Malaysia
  • 6 Department of Nephrology, Serdang Hospital, Selangor, Malaysia
  • 7 Department of Nephrology, Selayang Hospital, Selangor, Malaysia
  • 8 Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
JPEN J Parenter Enteral Nutr, 2021 02;45(2):422-426.
PMID: 32384179 DOI: 10.1002/jpen.1867

Abstract

BACKGROUND: Muscle wasting, prevalent in maintenance hemodialysis (HD) patients diagnosed with protein-energy wasting, represents an assessment challenge in the outpatient HD setting. Quadriceps muscle thickness (QMT) and cross-sectional area (CSA) assessment by ultrasound (US) is a potential surrogate measure for muscle wasting. We aimed to determine the validity of US to measure QMT and CSA against the gold standard-computed tomography (CT).

METHODS: Twenty-six patients on HD underwent US and CT scans on the same day, postdialysis session. QMT for rectus femoris (RF) and vastus intermedius (VI) muscles was taken at the midpoint (MID) and two-thirds (2/3) of both thighs and CSA of the RF muscle (RFCSA ), respectively. Correlation between US and CT measurements was determined by intraclass correlation coefficient (ICC) and Bland-Altman plot.

RESULTS: ICC (95% CI) computed between US and CT was 0.94 (0.87-0.97), 0.97 (0.93-0.99), 0.94 (0.87-0.97), 0.94 (0.86-0.97), and 0.92 (0.83-0.97) for RFMID , VIMID, RF2/3, VI2/3 , and RFCSA , respectively (all P < 0.001). Bland-Altman analysis indicated no bias in agreement between both methods.

CONCLUSION: The US imaging offers a valid and quick bedside assessment approach to assess muscle wasting in HD patients.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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