Reproducibility of ultrasound-derived muscle thickness and echo-intensity for the entire quadriceps femoris muscle.

INTRODUCTION: Muscle thickness (MT) and muscle echo-intensity (EI) allow the study of skeletal muscle adaptive changes with ultrasound. This study investigates the intra- and inter-session reliability and agreement of MT and EI measurements for each of the four heads of the quadriceps femoris in transverse and longitudinal scans, using two sizes for the region of interest (ROI); EI measurements only.

METHODS: Three B-mode images from two views were acquired from each head of quadriceps femoris from twenty participants (10 females) in two sessions, 7 days apart. EI was measured using a large and a small ROI. Reliability was examined with the mixed two-way intra-class correlation coefficient (ICC), the standard error of mean (SEM) and the smallest detectable change (SDC). Bland-Altman's plots were used to study agreement.

RESULTS: High to very high inter-session ICC values were found for MT for all muscle heads, particularly for measurements from transverse scans. For EI measurement, ICC values ranged from low to high, with higher ICC values seen with the largest ROI. SDC values ranged between 0.19 and 0.53 cm for MT and between 3.73 and 18.56 arbitrary units (a.u.) for two ROIs. Good agreement existed between MT measurements made in both scans. A small bias and larger 95% limits of agreement were seen for EI measurements collected with the two ROI sizes.

CONCLUSION: Ultrasound measures of MT and EI show moderate to very high reliability. The reliability and agreement of MT and EI measurements are improved in transverse scans and with larger ROIs.