Assessing Intensive Care Unit Acquired Weakness: An Observational Study Using Quantitative Ultrasound Shear Wave Elastography of the Rectus Femoris and Vastus Intermedius.

IF 2.4 3区医学 Q2 ACOUSTICS Ultrasound in Medicine and Biology Pub Date : 2024-11-12 DOI:10.1016/j.ultrasmedbio.2024.07.011

Sishu Yin, Shiying Zheng, Jie Li, Kaifan Chen, Hong Yang, Ping Wang

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Abstract

Introduction: Intensive care unit-acquired weakness (ICUAW) is associated with unfavorable outcomes. The current diagnostic tools for ICUAW are invasive, yield delayed results, and lack precision. This study explored the potential of shear wave elastography (SWE), an innovative ultrasound technique, to evaluate the quality changes in the lower extremity muscles of ICU patients, potentially aiding the early detection of ICUAW.

Materials and methods: We included adult patients diagnosed with ICUAW (average Medical Research Council score < 48) from December 2020 to October 2021. ICU patients were continuously monitored twice daily. Using ultrasonography, we measured the thickness (TH), cross-sectional area (CSA), pennation angle (PA), and SWE (SWE-values) modulus of the bilateral rectus femoris (RF) and vastus intermedius (VI). The diagnostic performance of each parameter was evaluated using sensitivity, specificity, and area under the receiver operating characteristic curve.

Results: Ultrasound quantification assessments were performed in 47 patients, 24 with ICUAW and 23 without ICUAW. Notably, PA decreased (RF: 11.33%, VI: 10.51%), while muscle rigidity increased (RF: 22.39%, VI: 22.50%) in ICUAW patients compared with non-ICUAW patients. The sensitivity and specificity for PA in the RF were 79.17% and 91.30%, respectively, and those for PA in VI were 79.17% and 78.26%, respectively. The use of both combinations yielded 91.67% and 73.91% sensitivity and specificity, respectively. Employing the PA of RF and SWE-values of RF together, we observed a diagnostic prediction sensitivity of 91.67% and a specificity of 60.87%.

Conclusions: ICUAW patients exhibited increased rigidity of the lower extremity muscles during their hospital stay. Ultrasonic SWE emerged as a reliable and objective tool, offering significant diagnostic value for ICUAW.

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评估重症监护室获得性虚弱：使用股直肌和腹中肌定量超声剪切波弹性成像的观察研究。

简介：重症监护室获得性虚弱（ICUAW）与不良预后有关。目前针对重症监护病房获得性肌无力的诊断工具具有创伤性、结果延迟且缺乏精确性。本研究探讨了剪切波弹性成像（SWE）这一创新型超声技术在评估 ICU 患者下肢肌肉质量变化方面的潜力，它可能有助于 ICUAW 的早期检测：我们纳入了 2020 年 12 月至 2021 年 10 月期间被诊断为 ICUAW 的成年患者（医学研究委员会平均评分小于 48 分）。每天两次对 ICU 患者进行连续监测。通过超声波检查，我们测量了双侧股直肌 (RF) 和中阔肌 (VI) 的厚度 (TH)、横截面积 (CSA)、垂线角 (PA) 和 SWE（SWE 值）模量。使用灵敏度、特异性和接收者操作特征曲线下面积评估了每个参数的诊断性能：对 47 例患者进行了超声量化评估，其中 24 例患有 ICUAW，23 例未患有 ICUAW。值得注意的是，与非 ICUAW 患者相比，ICUAW 患者的 PA 下降（RF：11.33%，VI：10.51%），而肌肉僵硬度增加（RF：22.39%，VI：22.50%）。RF 中 PA 的灵敏度和特异度分别为 79.17% 和 91.30%，VI 中 PA 的灵敏度和特异度分别为 79.17% 和 78.26%。两种组合的灵敏度和特异性分别为 91.67% 和 73.91%。同时使用 RF 的 PA 值和 RF 的 SWE 值，我们观察到诊断预测灵敏度为 91.67%，特异性为 60.87%：ICUAW患者在住院期间下肢肌肉僵硬度增加。超声波 SWE 是一种可靠而客观的工具，对 ICUAW 具有重要的诊断价值。

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来源期刊

Ultrasound in Medicine and Biology 医学-核医学

CiteScore

6.20

自引率

6.90%

发文量

325

审稿时长

70 days

期刊介绍： Ultrasound in Medicine and Biology is the official journal of the World Federation for Ultrasound in Medicine and Biology. The journal publishes original contributions that demonstrate a novel application of an existing ultrasound technology in clinical diagnostic, interventional and therapeutic applications, new and improved clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and the interactions between ultrasound and biological systems, including bioeffects. Papers that simply utilize standard diagnostic ultrasound as a measuring tool will be considered out of scope. Extended critical reviews of subjects of contemporary interest in the field are also published, in addition to occasional editorial articles, clinical and technical notes, book reviews, letters to the editor and a calendar of forthcoming meetings. It is the aim of the journal fully to meet the information and publication requirements of the clinicians, scientists, engineers and other professionals who constitute the biomedical ultrasonic community.

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