Sonoelastography to Assess Muscular Stiffness Among Older Adults and its Use for the Diagnosis of Sarcopenia: A Systematic Review

Ewa Magdalena Janczyk; Noémie Champigny; Emeline Michel; Charles Raffaelli; Cédric Annweiler; Raphael Zory; Olivier Guérin; Guillaume Sacco

doi:10.1055/a-1293-8057

Ultraschall in der Medizin - European Journal of Ultrasound, Inhaltsverzeichnis

Ultraschall Med 2021; 42(06): 634-642
DOI: 10.1055/a-1293-8057

Review

Sonoelastography to Assess Muscular Stiffness Among Older Adults and its Use for the Diagnosis of Sarcopenia: A Systematic Review

Sonoelastografie zur Beurteilung der Muskelsteifheit bei älteren Erwachsenen und ihr Einsatz in der Diagnose der Sarkopenie: Eine systematische Übersichtsarbeit

Ewa Magdalena Janczyk

¹Department of Therapeutic and Geriatric Medicine, University Hospital Centre of Nice, Côte d’Azur University, Nice, France

,

Noémie Champigny

¹Department of Therapeutic and Geriatric Medicine, University Hospital Centre of Nice, Côte d’Azur University, Nice, France

,

Emeline Michel

¹Department of Therapeutic and Geriatric Medicine, University Hospital Centre of Nice, Côte d’Azur University, Nice, France

²LAMHESS UPR 6312, Côte d’Azur University, Nice, France

,

Charles Raffaelli

³Department of Ultrasounds, University Hospital Centre of Nice, Côte d’Azur University, Nice, France

,

Cédric Annweiler

⁴Robarts Research Institute, Department of Medical Biophysics, University of Western Ontario Schulich School of Medicine and Dentistry, London, Canada

⁶UPRES EA 4638, University of Angers, France

⁷Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France

,

Raphael Zory

²LAMHESS UPR 6312, Côte d’Azur University, Nice, France

,

Olivier Guérin

¹Department of Therapeutic and Geriatric Medicine, University Hospital Centre of Nice, Côte d’Azur University, Nice, France

⁵Institute for Research on Cancer and Aging Nice (IRCAN) CNRS UMR 7284/INSERM U108, Côte d’Azur University, Nice, France

,

Guillaume Sacco

⁶UPRES EA 4638, University of Angers, France

⁸Research Center Edmon and Lily Safra, Memory Clinic, University Hospital Centre Nice, Côte d’Azur University, Nice, France

⁹CoBTek Lab UPR 7276, Côte d’Azur University, Nice, France

› Institutsangaben

Abstract

Changes in muscle stiffness have been reported with sarcopenia. Sonoelastography is an accessible and non-radiating imaging technique allowing quantification of elastic properties of tissue. We performed a systematic review of the literature to investigate whether sonoelastography can be a reliable method to assess sarcopenia in older patients. We searched Medline, Google Scholar, Scopus, SpringerLink and Science direct from January 1, 1990 to April 1, 2020. Three independent review authors assessed trial eligibility, extracted the data, and assessed risk of bias. We intended to learn which types of elastography have been tested, if such measures are repeatable, and if they have been compared to the currently accepted diagnostic method. Ten studies met the inclusion criteria. Most followed a cross-sectional design with young and older adult subgroups. The gastrocnemius, rectus femoris, and vastus intermedius appeared most frequently. Nine of the included studies used shear wave elastography and one-strain elastography. The passive elastic constant was significantly greater in sarcopenic versus healthy subjects after passive stretching (124.98 ± 60.82 vs. 46.35 ± 15.85, P = 0.004). However, even in non-sarcopenic patients, the age of the patient was responsible for about 45.5 % of the variance in SWV. Among ten included articles, four reported higher stiffness in the muscles of older adults, two reported lower stiffness, and four found no significant difference. Due to the substantial heterogenicity of actual data, we could not make any conclusions about the potential usefulness of elastography to assess sarcopenia. Further studies are needed, including a larger sample of older patients and using a standardized and reproducible protocol.

Zusammenfassung

Bei Sarkopenie wurden Veränderungen der Muskelsteifheit berichtet. Die Sonoelastografie ist eine einfach zugängliche und strahlungsfreie Bildgebungstechnik, die die Quantifizierung der elastischen Eigenschaften des Gewebes ermöglicht. Wir führten eine systematische Überprüfung der Literatur durch, um zu untersuchen, ob die Sonoelastografie eine zuverlässige Methode zur Beurteilung der Sarkopenie bei älteren Patienten sein kann. Wir haben MEDLINE, Google Scholar, Scopus, SpringerLink und ScienceDirect vom 1. Januar 1990 bis zum 1. April 2020 durchsucht. Drei unabhängige Review-Autoren bewerteten die Eignung der Studien, extrahierten die Daten und schätzten das Bias-Risiko ein. Wir wollten herausfinden, welche elastografischen Methoden eingesetzt wurden, ob entsprechende Messungen wiederholbar sind und ob sie mit der derzeit anerkannten Diagnostik verglichen wurden. Zehn Studien erfüllten die Einschlusskriterien. Die meisten folgten einem Querschnittsdesign mit Untergruppen von jungen und älteren Erwachsenen. Am häufigsten wurden M. gastrocnemius, M. rectus femoris und M. vastus intermedius untersucht. Neun der eingeschlossenen Studien verwendeten Scherwellen-Elastografie und eine Strain-Elastografie. Die passive Elastizitätskonstante war bei sarkopenischen gegenüber gesunden Probanden nach passiver Dehnung signifikant höher (124,98 ± 60,82 vs. 46,35 ± 15,85; p = 0,004). Selbst bei nichtsarkopenischen Patienten war das Alter des Patienten für etwa 45,5 % der Varianz der SWV verantwortlich. Von den 10 eingeschlossenen Arbeiten berichteten 4 über eine höhere Steifheit in den Muskeln älterer Erwachsener, 2 über eine geringere Steifheit und 4 fanden keinen signifikanten Unterschied. Aufgrund der erheblichen Heterogenität der derzeitigen Daten konnten wir den potenziellen Nutzen der Elastografie zur Bewertung der Sarkopenie nicht abschließend beurteilen. Es sind weitere Studien erforderlich, einschließlich einer größeren Stichprobe älterer Patienten und dem Einsatz eines standardisierten und reproduzierbaren Protokolls.

Key words

older adults - sarcopenia - elastography - sonoelastography - elasticity imaging techniques

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Referenzen

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