VISUAL ASSESSMENT OF SEGMENTAL MUSCLE ULTRASOUND IMAGES IN SPINA BIFIDA APERTA

In spina bifida aperta (SBA), spinal MRI provides a surrogate marker to estimate muscle damage caudal to the myelomeningocele (MMC). This muscle damage by the MMC can be quantified by intra-individual comparison of muscle ultrasound density (MUD) caudal versus cranial to the MMC (dMUD 5 [MUDcaudal-to-the-MMC] - [MUDcranial-to-the-MMC]). Quantitative dMUD assessment requires time, equipment and expertise, whereas it could also be visually determined by differences in muscle echodensity caudal vs. cranial to the MMC (visual-dMUD). If visual and quantitative dMUD correspond, visual dMUD assessment could provide a clinical screening parameter. In 100 SBA muscle ultrasound recordings of patients with various MMC levels, we aimed to compare quantitative dMUD (dMUD = [MUDcalf-muscle/S1] - [MUDquadriceps-muscle/L2-L4]) with visual dMUD assessments by 20 different observers. Results indicate that quantitative dMUD can be visually detected (sensitivity 86%; specificity 57%), implicating that visual dMUD screening could provide a quick, clinical screening tool for muscle impairment by the MMC. (E-mail: d.a.sival@umcg.nl) (C) 2012 World Federation for Ultrasound in Medicine & Biology.