{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:46:13Z","timestamp":1786977973392,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T00:00:00Z","timestamp":1653091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"published-print":{"date-parts":[[2022,9]]},"abstract":"Abstract<\/jats:title>\n \n Purpose<\/jats:title>\n In advanced muscular dystrophies (AMD), quantification of muscle echo\u2010intensity (EI) may be influenced by ultrasound beam attenuation, due to fibrosis and fatty infiltration of muscle tissue. Objective of the study was to compare EI measurements using grayscale analysis between a superficial and whole\u2010muscle region of interest (ROI) in subjects with advanced and mild\u2010to\u2010moderate muscular dystrophy (MMD).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Thirty\u2010two adult subjects diagnosed with a muscular dystrophy and twenty\u2010five matched healthy controls underwent ultrasound assessment of the biceps brachii (BB), rectus femoris (RF) and tibialis anterior (TA) muscles. Based on Heckmatt grading scale of muscles, two disease groups, an AMD (Heckmatt grades 3 or 4) and a MMD (Heckmatt grade 2), were analyzed. Superficial ROI was set as one\u2010fourth of the whole\u2010muscle area, located immediately below the superficial fascia and always inside muscle boundaries.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Muscle EI was significantly higher in the superficial compared to whole\u2010muscle ROI, in all evaluated muscle groups of AMD subjects (BB,\n p<\/jats:italic>\n \u00a0=\u00a00.004\/RF,\n p<\/jats:italic>\n \u00a0=\u00a00.027\/TA,\n p<\/jats:italic>\n \u00a0=\u00a00.002). EI values in superficial ROIs, for individual muscle analysis using\n z<\/jats:italic>\n \u2010scores, were more representative in assessments of muscle abnormality in advanced stages of the disease course (Heckmatt grades 3 and 4). In MMD and healthy muscles, no statistical difference was found in EI measurements between the two ROI types.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In AMD, selection of superficial ROI is better representative of changes in muscle texture, although caution should be exercised when comparing ROIs of different sizes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jcu.23243","type":"journal-article","created":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T07:50:14Z","timestamp":1653119414000},"page":"1013-1019","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effect of beam attenuation on muscle ultrasound echogenicity measurement in muscular dystrophies"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3354-1279","authenticated-orcid":false,"given":"Kanellos C.","family":"Spiliopoulos","sequence":"first","affiliation":[{"name":"Department of Neurology, School of Medicine University of Patras Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitra","family":"Veltsista","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine University of Patras Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavroula","family":"Bara","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, School of Medicine University of Patras Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Vlachopoulos","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, School of Medicine University of Patras Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Costaridou","sequence":"additional","affiliation":[{"name":"Department of Medical Physics, School of Medicine University of Patras Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9237-4963","authenticated-orcid":false,"given":"Elisabeth","family":"Chroni","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine University of Patras Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.physiol.010908.163216"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2014.00172"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12210"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics10060400"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27081"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000000245"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1179\/1743132811Y.0000000010"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2011.10.020"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2012.04.020"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24296"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(82)80286-2"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/cpf.12175"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2006.05.028"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2016.02.012"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-9037-y"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009211"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24904"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2012.06.001"}],"container-title":["Journal 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