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Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (5): 843-849. doi: 10.19723/j.issn.1671-167X.2021.05.006

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Measurement and evaluation of the quadriceps muscle mass in young men based on magnetic resonance imaging

WU Yi-fan,ZHANG Xiao-yuan,REN Shuang,YU Ying-xiang,CHANG Cui-qing()   

  1. Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China
  • Received:2021-06-04 Online:2021-10-18 Published:2021-10-11
  • Contact: Cui-qing CHANG E-mail:changcuiqing@126.com

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Abstract:

Objective: To investigate the correlation between the quadriceps cross-sectional area (CSA) and quadriceps muscle volume (QMV) at different horizontal levels from the upper edge of the patella, and to determine the best observation position. Methods: Thigh magnetic resonance imaging (MRI) images of 22 Chinese young men [age: (29±6) years] with anterior cruciate ligament (ACL) rupture were examined. The CSA was measured at 18, 15, and 12 cm above the upper edge of the pate-lla (denoted by CSA-18, CSA-15 and CSA-12 respectively), and the QMV and CSA were determined by semiautomatic segmentation. A curve model was established to estimate QMV. Bland-Altman analysis was performed to determine the confidence limits of the volumes. Results: On the unaffected side, the mean QMV was (1 944.45±323.77) cm3. The quadriceps CSA at the upper edge of the patella at 18, 15, and 12 cm was (80.80±12.16) cm2, (77.53±12.03) cm2, and (72.68±10.51) cm2, respectively. The coefficients of determination (R2), ascertained using curve estimation models, for the 3 positions were 0.819, 0.755, and 0.684 (P<0.001), and the standard deviations of the volume estimated value (SEE) were 7.4%, 8.7%, and 9.8%. The fitting equations of the three horizontal positions were all good, but the fitting degree of CSA-18 was the highest. The Bland-Altman scatter plot showed that the arithmetic means of the QMV at 18, 15 and 12 cm from the upper edge of the patella 0.8 cm3, -1.1 cm3, and 0.9 cm3 and 95% limits of agreement (LoA) were (-268.8, 270.5), (-315.2, 313.1), and (-355.7, 357.5), respectively. The estimated QMV was in good agreement with the measured value. The difference between the estimated CSA-18 and measured values was the smallest. The results on the affected side were consistent. Conclusion: The correlation between QMV and CSA in the young men with the upper edge of patella as baseline was reliable and consistent. Among them, CSA-18 had the highest correlation with the QMV. However, different observation sites could be selected for different injuries of the quadriceps.

Key words: Magnetic resonance imaging, Quadriceps muscle, Cross-sectional area, Measurement

CLC Number: 

  • R873

Figure 1

The MRI images of the participants in the image analysis software A, the establishment of the quadriceps mask (the threshold is 60); B, the area encircled in color shows the quadriceps CSA in both sides; C, the regions with red line show the rectus femoris (RF), vastus medialis (VM), vastus internus (VI), vastus lateralis (VL), respectively."

Table 1

CSA of quadriceps (n=22, x ?±s)"

Items CSA of quadriceps/cm2 F value P value
CSA-18 CSA-15 CSA-12
Unaffected side
Quadriceps 80.80±12.16 77.53±12.03 72.68±10.51 92.876 <0.001
RF 9.53±2.36 7.01±1.67 3.66±1.28 209.987 <0.001
VM 14.97±3.46 20.09±4.51 23.04±4.90 336.556 <0.001
VL 28.71±4.93 25.84±4.71 22.06±3.85 121.180 <0.001
VI 27.59±4.58 24.60±4.11 21.19±3.95 132.113 <0.001
Affected side
Quadriceps 73.79±15.83 71.16±15.25 66.41±14.02 58.739 <0.001
RF 9.49±2.34 7.05±1.86 4.24±1.19 226.089 <0.001
VM 13.43±3.89 17.78±4.37 22.29±5.46 239.172 <0.001
VL 26.07±6.73 23.63±5.90 20.23±5.35 58.258 <0.001
VI 24.80±5.10 22.70±5.08 19.64±4.48 101.731 <0.001

Table 2

Correction analysis between CSA and QMV, height and weight"

Items Unaffected side Affected side
r R2 P value r R2 P value
QMV
CSA-18 0.891 0.793 <0.001 0.953 0.909 <0.001
CSA-15 0.843 0.711 <0.001 0.926 0.857 <0.001
CSA-12 0.808 0.652 <0.001 0.904 0.818 <0.001
Height 0.404 0.163 0.062 0.447 0.199 0.037
Weight 0.705 0.497 <0.001 0.658 0.433 0.001
Height
CSA-18 0.135 0.018 0.548 0.247 0.061 0.268
CSA-15 0.058 0.003 0.796 0.197 0.039 0.378
CSA-12 -0.025 0.001 0.912 0.196 0.038 0.383
Weight
CSA-18 0.657 0.432 0.001 0.571 0.326 0.005
CSA-15 0.597 0.357 0.003 0.567 0.322 0.006
CSA-12 0.509 0.259 0.016 0.508 0.258 0.016

Table 3

Fitting equation of the QMV"

R2 SEE F value P value Constant b1 b2
Unaffected side
CSA-18 0.819 144.64 43.111 <0.001 -2 221.800 79.618 -0.340
CSA-15 0.755 168.51 29.265 <0.001 -2 506.692 92.559 -0.443
CSA-12 0.684 191.29 20.580 <0.001 -2 311.765 93.240 -0.468
Affected side
CSA-18 0.923 123.05 114.104 <0.001 -1 423.204 62.000 -0.247
CSA-15 0.883 151.52 72.009 <0.001 -1 766.642 75.312 -0.349
CSA-12 0.871 159.67 63.904 <0.001 -1 992.903 87.521 -0.451

Table 4

The estimated value and the measured value of QMV (n=22, x ?±s)"

QMV Unaffected side Affected side
Measured value/cm3 1 944.45±323.77 1 747.36±422.18
Estimated value of CSA-18/cm3 1 943.62±292.85 1 747.76±405.79
Estimated value of CSA-15/cm3 1 945.52±281.62 1 747.83±396.99
Estimated value of CSA-12/cm3 1 943.54±267.56 1 745.81±393.31

Figure 2

Establishment of the curve model of QMV (A-C, unaffected side; D-F, affected side) Abbreviations as in Table 2."

Figure 3

The Bland-Altman scatter plots indicate the difference between estimated value of CSA-18, CSA-15, and CSA-12 and the measured value of QMV in bilateral quadriceps (A-C, unaffected side; D-F, affected side) Abbreviations as in Table 2. Mean values of QMV = (estimated value + measured value)/2; Difference of QMV = measured value-estimated value."

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