超音波検査による嚥下関連筋の量的・質的評価の信頼性

Reliability of ultrasound for the quantitative and qualitative evaluation of swallow-related muscles

　本研究では，超音波検査による高齢者の嚥下関連筋の筋量と筋の質の評価の信頼性を検証した．高齢者12名を対象とし，超音波検査は検者A（走査歴3年）とB（走査歴25年）が行った．さらに，検者Aは初回の検査から3〜7日後に2回目の検査（再テスト）を実施した．すべての超音波画像は検者Aが解析した．解析項目は，「舌の厚み」，「オトガイ舌骨筋の面積と輝度」，「顎二腹筋前腹の面積と輝度」とした．級内相関係数（ICC）を用いて検者Aの検者内信頼性，再テスト信頼性，検者AとBの検者間信頼性を検討した．すべての解析項目において，検者Aの検者内信頼性，再テスト信頼性および検者間信頼性はICC 0.7以上であった．すべての解析項目は，1回のみの描出でも，検査期間を空けても，検者を変えて評価しても，高い信頼性で評価できることを確認できた．

　This study aimed to evaluate the reliability of ultrasonography for assessing the mass and quality of swallow-related muscles of the elderly. Twelve elderly subjects were included in the study. Ultrasonography was conducted by examiner A, who had 3 years of scanning experience, and examiner B, who had 25 years of scanning experience. During a period of 3 to 7 days after the initial examination, examiner A performed a second examination (re-test) and analyzed all ultrasound images. The following factors were examined：thickness of the tongue, the area and brightness of the geniohyoid muscle, and the area and brightness of the anterior belly of digastric muscle. Intraclass correlation coefficient (ICC) was determined to evaluate the intra-examiner reliability of examiner A, the test-retest reliability, and inter-examiner reliability of examiners A and B. All factors and intra- and inter-examiner reliability, test-retest reliability of examiner A exceeded the ICC of 0.7. Thus, it was concluded that all factors could be assessed with a high reliability, even though only one drawing was prepared, the examination period was spaced, and different examiners were involved in the assessments.