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Title: Novel high-quality sonographic methods to diagnose muscle wasting in long-stay critically ill patients: Shear wave elastography, superb microvascular imaging and contrast-enhanced ultrasound
Authors: Hernández Socorro, Carmen Rosa 
Saavedra Santana, Pedro 
López Fernández, Juan Carlos 
Lübbe-Vazquez, Federico
Ruiz Santana, Sergio 
UNESCO Clasification: 32 Ciencias médicas
241110 Fisiología del músculo
320111 Radiología
Keywords: Critical illness
Muscle mass
Muscle weakness
Quadriceps femoris, et al
Issue Date: 2021
Journal: Nutrients 
Abstract: Novel ultrasound (US) methods are required to assess qualitative changes in the quadriceps rectus femoris (QRF) muscle when evaluating mechanically ventilated, long-stay ICU patients with suspected neuromuscular acquired weakness (ICUAW). Our aim was to analyze novel US muscle assessment methods in these patients versus healthy controls by carrying out a prospective observational study. Shear wave elastography (SWE) showed, with a receiver operating characteristic (ROC) curve of 0.972 (95% confidence interval (CI) = 0.916–1.000), that patients increased muscle stiffness associated with muscle fibrosis when diagnosed with ICUAW. We also performed, for the first time, superb microvascular imaging (SMI), which is an innovative US technique designed for imaging microvascularization unseen with color Doppler US, and observed that 53.8% of cases had significantly lower QRF muscle microvascular angiogenic activity than controls (p < 0.001). Finally, we used contrast-enhanced ultrasound (CEUS) to analyze maximum and minimum QRF muscle perfusion and obtained a ROC curve of 0.8, but when used as markers for SMI, their diagnostic capacity increased to 0.988 (CI = 0.965–1) and 0.932 (CI = 0.858–1), respectively. These findings show, for the first time, that these novel sonographic muscle methods should be used for their diagnostic capacity when assessing sarcopenic processes associated with this group of critically ill patients.
ISSN: 2072-6643
DOI: 10.3390/nu13072224
Source: Nutrients [ISSN 2072-6643], v. 13(7), 2224, (Junio 2021)
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