Quantitative muscle ultrasound in childhood neuromuscular disorders
Sigrid Pillen, Radboud University Medical Center
The thesis describes the use of muscle ultrasound for the detection of neuromuscular disorders and its ability to accurately visualize changes in muscle thickness and texture. Using this patient-friendly technique it was possible to reliably detect neuromuscular disorders in children with positive and negative predictive values of around 90%. The use of quantitative computer-aided grey-value analysis of the ultrasound images significantly improved the sensitivity and accuracy of the technique over simple visual analysis of the images. This means that muscle ultrasound result can help in deciding whether additional, often more invasive or uncomfortable investigations such as EMG or muscle biopsy are necessary. It can also help determine the most affected (area within the) muscle to guide the optimal biopsy site, increasing the chance of making the right diagnosis. Recently our research also confirmed it is possible to non-invasively detect fibrillations with ultrasound, expanding the diagnostic possibilities of the technique. The thesis further describes the technical background of muscle ultrasound and provides a practical guide for using it in daily clinical practice. Besides its role in the diagnostic workup of children with a suspected neuromuscular disorder, the future role of muscle ultrasound will also include its use as a follow-up tool for new treatment modilaties on muscle structure and thickness. Several lines of research have already been initiated for this purpose.
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