Reliability of ultrasound elastography for the quantification of transversus abdominis elasticity

BACKGROUND: The transversus abdominis (TrA), which is considered to be involved in controlling spinal stability, is covered by two muscles (i.e. the external and internal oblique muscles) as well as subcutaneous fat. Therefore, there were doubts about whether it was possible to perform highly reliable measurements of muscle elasticity. PURPOSE: To investigate the reliability of ultrasound elastography for the quantification of elasticity of the TrA. MATERIAL AND METHODS: A skilled and an unskilled operator of ultrasound elastography measured TrA elasticity in 10 healthy men (age, 24 ± 4 years; height, 172.0 ± 5.2 cm; weight, 72.3 ± 12.0 kg) in the supine position. The tests were repeated six times; of the six measured values, a group of four measurements showing the lowest coefficient of variation (CV) was adopted and the mean values were used for further analysis. This procedure was repeated twice on each participant on two different days. RESULTS: The intra-class correlation coefficients (ICCs) between days for skilled and unskilled operators were 0.86 (P < 0.00) and 0.59 (P = 0.02), respectively, and the CVs were 8.7% and 13.8%, respectively. The ICCs between operators and CVs were in the range of 0.56–0.57 (P = 0.02–0.03) and 13.5–15.5%, respectively. No systematic error was found for any comparison. CONCLUSION: The reliabilities of the skilled and unskilled operators were high and moderate, respectively.