肌肉减少症：解决诊断问题的现代方法

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肌肉减少症是医学统计和医疗保健系统的一个相对较新的诊断。然而，由于大量可能的不良后果，例如跌倒风险增加、残疾、住院时间延长和死亡率增加，它对医疗体系造成了社会和经济负担。虽然肌肉减少症没有高度专业化的药物疗法，但预防和及时的非药物治疗可以降低潜在不良反应的风险。诊断»肌肉减少症»不仅需要确认肌力下降，还需要确认肌肉质量下降。仪器诊断包括双能X光吸收测量 (DXA) 和生物阻抗测定法 (BIA)等方法。 这些方法可以辅以人工智能 (AI) 算法，用于在计算机断层扫描和磁共振图像上自动分割肌肉和脂肪组织，然后计算L3椎骨水平的肌肉骨骼指数。 此类软件在莫斯科市统一医疗信息和分析系统 (ERIS EMIAS)统一放射信息服务等系统中使用时，为机会性筛查提供了机会。然而，尽管欧洲老年人肌肉减少症工作组将CT和MRI技术认定为“金标准”，但仍然没有公认的用于诊断肌肉减少症的CT 和MR定量L3介质值。除此之外，还有统一术语“肌肉骨骼指数”的问题。如果这些问题通过进一步的人群研究得到解决，将有可能获得一种用于肌肉减少症的仪器诊断的新方法，并随后将其用于筛查这种疾病。

作者简介

Anastasia K. Smorchkova

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Email: a.smorchkova@npcmr.ru
ORCID iD: 0000-0002-9766-3390
SPIN 代码: 4345-8568
Scopus 作者 ID: 57213145638
俄罗斯联邦, Moscow

Alexey V. Petraikin

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Email: alexeypetraikin@gmail.com
ORCID iD: 0000-0003-1694-4682
SPIN 代码: 6193-1656

MD, Cand. Sci. (Med.)

俄罗斯联邦, Moscow

Dmitry S. Semenov

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Email: d.semenov@npcmr.ru
ORCID iD: 0000-0002-4293-2514
SPIN 代码: 2278-7290
Scopus 作者 ID: 57213154475
Researcher ID: P-5228-2017
俄罗斯联邦, Moscow

Daria E. Sharova

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

编辑信件的主要联系方式.
Email: d.sharova@npcmr.ru
ORCID iD: 0000-0001-5792-3912
SPIN 代码: 1811-7595
俄罗斯联邦, Moscow

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2. *图1年轻（a-d）和老年（e-h）妇女不同身体质量指数（BMI）值的双能量X射线吸收仪（根据D.J. Tomlinson等人[43]）获得的诊断图像实例。用蓝色的标记骨组织，用红色的标记无脂肪的肌组织，用黄色的标记脂肪组织。

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3. *图2使用J. Ha等人[46]的L3SEG-net AI算法在L3水平上对测量肌组织的、皮下脂肪组织和内脏脂肪组织进行切片的面积测量实例（单位：cm2）。自左而右用红色标记皮下脂肪组织，用紫色标记骨骼肌肉量，用绿色标记内脏脂肪组织。 *可以在Creative Commons Attribution 4.0 International License (CC BY 4.0), Scientific Reports上找到。

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4. *图3用网络的自动工具获得的肌肉组织质量图（根据D.W. Kim等人[59]）。IMAT: 肌间脂肪组织区；LAMA：低密度肌肉组织区；NAMA：正常密度肌肉组织区；SMA：骨骼肌区；TAMA：腹部的肌肉组织一般区。 *可以在Creative Commons Attribution 4.0 International License (CC BY 4.0), JMIR Medical Informatics上找到。

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