Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 26, 47
eCollection

Test-retest Reliability of Nerve and Muscle Morphometric Characteristics Utilizing Ultrasound Imaging in Individuals With Unilateral Sciatica and Controls

Affiliations

Test-retest Reliability of Nerve and Muscle Morphometric Characteristics Utilizing Ultrasound Imaging in Individuals With Unilateral Sciatica and Controls

Hadi Sarafraz et al. Chiropr Man Therap.

Abstract

Background: Ultrasound imaging has been suggested for studying the structure and function of nerves and muscles; however, reliability studies are limited to support the usage. The main aim of this study was to explore the intrarater within-session reliability of evaluating the sciatic nerve and some related muscles morphology by ultrasound imaging.

Methods: Three B-mode images from two scans (transverse and longitudinal) were acquired from the multifidus, biceps femoris, soleus and medial gastrocnemius muscles bilaterally from 15 participants with sciatica and 15 controls in one session, 1-h apart. The data were collected from March to July 2017. Contraction ratio was measured only by longitudinal scan, while the echo intensity was measured using maximum rectangular region of interest in two scans (transverse and longitudinal) for all muscles. Cross-sectional area, direct (tracing) and indirect (ellipsoid formula) methods were used to measure the sciatic nerve. Intraclass correlation coefficient (ICC 3,1), standard error of measurement and minimal detectable change were calculated.

Results: Good to high ICCs (0.80-0.96) were found for muscle contraction ratio in the longitudinal scans in all the muscles in both sciatica and control groups. For echo intensity measurements ICCs ranged from moderate to high, with higher ICCs seen with the maximum region of interest in the transverse scans. The minimal detectable change values ranged between 0.11 and 0.53 cm for contraction ratio.

Conclusions: Ultrasound imaging has high intrarater within-session reliability for assessing the sciatic nerve Cross-sectional area and muscle contraction ratios. Transverse scans with the maximum region of interest result in higher reliability. The sciatic Cross-sectional area is most accurately measured utilizing the direct tracing method rather than the indirect ellipsoid method.

Keywords: Low back pain; Reproducibility; Sciatic nerve; Skeletal muscle; Ultrasonography.

Conflict of interest statement

All participants signed a consent form and the study was approved by the Human Ethics Committee at Tehran University of Medical Sciences, Tehran, Iran.Written informed consent was obtained from the participants for publication of their individual details and accompanying images in this manuscript. The consent form is held by the first author and is available for review by the Editor-in-Chief.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Muscle thickness in the longitudinal scan, the distance between the superficial and deep fascia. In the the longitudinal scan, the US probe is placed parallel to the longitudinal axis of the target structure. MG: medial gastrocnemius muscle, SOL: soleus muscle
Fig. 2
Fig. 2
Maximum region of interest (ROI) with histogram echo intensity in the longitudinal scan. A maximum ROI was defined for each image to include as much of the muscle as possible, avoiding bone and surrounding fasciae. Histogram quantifies the greyscale of each pixel in arbitrary units. MG: medial gastrocnemius muscle, SOL: soleus muscle
Fig. 3
Fig. 3
Maximum region of interest with histogram echo intensity in the transverse scan. In the transverse scan, the US probe should be placed perpendicular to the structure of interest. MG: medial gastrocnemius muscle, SOL: soleus muscle
Fig. 4
Fig. 4
Maximum rectangular region of interest with histogram echo intensity in the longitudinal scan. MG: medial gastrocnemius muscle, SOL: soleus muscle
Fig. 5
Fig. 5
Maximum rectangular region of interest (ROI) with histogram echo intensity in the transverse scan. Rectangular ROI was chosen in each scan to include as much of the muscle as possible without any bone or surrounding fascia. MG: medial gastrocnemius muscle, SOL: soleus muscle
Fig. 6
Fig. 6
Sciatic nerve with trace cross-sectional area. In the direct method, the inner border of the perineural echogenic rim that surrounds the hypoechoic sciatic nerve was traced, and measured nerve area by tracing along the hyperechoic epineurium, approximating inside of the epineurium. BF: biceps femoris muscle, SM: semimembranosus muscle
Fig. 7
Fig. 7
Sciatic nerve with ellipse cross-sectional area. The major and minor diameters and the formula of an ellipsoid to calculate the area (major diameter × minor diameter × 3.14/4)

Similar articles

See all similar articles

References

    1. Nijs J, Apeldoorn A, Hallegraeff H, Clark J, Smeets R, Malfliet A, et al. Low back pain: guidelines for the clinical classification of predominant neuropathic, nociceptive, or central sensitization pain. Pain Physician. 2015;18(3):E333–E346. - PubMed
    1. Checchia GA, Letizia Mauro G, Morico G, Oriente A, Lisi C, Polimeni V, et al. Observational multicentric study on chronic sciatic pain: clinical data from 44 Italian centers. Eur Rev Med Pharmacol Sci. 2017;21(7):1653–1664. - PubMed
    1. Hobson-Webb LD, Cartwright MS. Advancing neuromuscular ultrasound through research: finding common sound. Muscle Nerve. 2017;56(3):375–378. doi: 10.1002/mus.25621. - DOI - PubMed
    1. Vlychou M, Teh J. Ultrasound of muscle. Curr Probl Diagn Radiol. 2008;37(5):219–230. doi: 10.1067/j.cpradiol.2007.08.006. - DOI - PubMed
    1. Mayans D, Cartwright MS, Walker FO. Neuromuscular ultrasonography: quantifying muscle and nerve measurements. Phys Med Rehabil Clin N Am. 2012;23(1):133–148. doi: 10.1016/j.pmr.2011.11.009. - DOI - PMC - PubMed

Publication types

Feedback