Objective:

To explore the application value of high-frequency ultrasound combined with two-dimensional shear wave elastography (2D-SWE) in diagnosing low muscle mass in patients with cirrhosis.

Approach:

• Study Design: 135 patients with cirrhosis were categorized into Cirrhosis and CRS groups based on Arm Skeletal Muscle Index (ASMI), with 66 healthy individuals as controls.
• Data Collection: General characteristics, biochemical parameters, liver elastic modulus (LEM), muscle thickness (MT), and shear wave velocity (SWV) were analyzed.
• Statistical Analysis: Pearson correlation and stepwise logistic regression were used to identify associations, and receiver operating characteristic curves were generated for diagnostic performance.

Key Findings:

• CRS group showed lower MT and muscle SWV, but higher LEM compared to NC and cirrhosis groups (p < 0.05).
• ASMI positively correlated with BMI, serum albumin, MT, and muscle SWV; negatively correlated with age, total bilirubin, LEM, and INR (all p < 0.05).
• MG-SWV, RF-MT, and LEM were independently associated with CRS (all p < 0.05).
• Combined application of muscle parameters and LEM had an AUC of 0.919, with sensitivity of 90.57% and specificity of 83.13%, outperforming single parameters.

Interpretation:

Ultrasound measurement of LEM, MT, and muscle SWV provides a diagnostic approach for CRS, with combined assessment enhancing diagnostic accuracy.

Limitations:

• The study was conducted in a single tertiary hospital, which may limit generalizability.
• The sample size may not capture all variations in cirrhotic patients.

Conclusion:

Ultrasound assessment of muscle metrics and liver stiffness may serve as a diagnostic tool for low muscle mass in cirrhotic patients.