Ultrasound versus electromyography for the detection of fasciculation in amyotrophic lateral sclerosis: systematic review and meta-analysis

Abstract The objective of this study was to determine the diagnostic accuracy of ultrasound and electromyography for the detection of fasciculation in patients with amyotrophic lateral sclerosis and to compare detection rates between the two methods. By searching the Cochrane Library, MEDLINE, Excerpta Medica, and Latin-American and Caribbean Health Sciences Literature databases, we identified studies evaluating the diagnostic accuracy and fasciculation detection rates of ultrasound and electromyography. The Quality Assessment of Diagnostic Accuracy Studies, version 2, and RTI item bank tools were used for the evaluation of methodological quality. Ultrasound, for 10 s or 30 s, had a higher detection rate than did electromyography in all muscles evaluated. The overall detection rate (in patients) did not differ significantly between ultrasound for 10 s and ultrasound for 30 s. The accuracy of ultrasound for 10 s was 70% in muscles and 85% in patients. The accuracy of ultrasound for 30 s was 82% in patients. Ultrasound provided detection rates superior to those achieved with electromyography, independent of the examination time and muscles evaluated.

摘要 本研究旨在明确超声（ultrasound）与肌电图（electromyography）检测肌萎缩侧索硬化症（amyotrophic lateral sclerosis）患者肌束震颤的诊断准确性，并对比两种方法的检出率。研究通过检索考克兰图书馆（Cochrane Library）、MEDLINE数据库、《医学文摘》（Excerpta Medica）以及拉丁美洲与加勒比健康科学文献数据库（Latin-American and Caribbean Health Sciences Literature），筛选了评估超声与肌电图诊断准确性及肌束震颤检出率的相关研究。采用诊断准确性研究质量评估量表第2版（Quality Assessment of Diagnostic Accuracy Studies, version 2）与RTI项目库工具（RTI item bank tools）对纳入研究的方法学质量进行评价。结果显示，在所有评估的肌肉中，扫描时长为10秒或30秒的超声检出率均高于肌电图；在患者整体检出率层面，10秒超声与30秒超声的检出率无显著统计学差异。10秒超声对单块肌肉的诊断准确率为70%，对患者群体的诊断准确率为85%；30秒超声对患者群体的诊断准确率为82%。无论检查时长与评估肌肉类型如何，超声的肌束震颤检出率均优于肌电图。