The histological samples were obtained from the previously marked area of the cadaver specimens and were fixated in blocks with a 20% formalin solution. These blocks were then processed for H&E staining to obtain histological slices for general morphological analysis. All preparations were examined and measured with a Leica DMD 108 microscope.
The histological scoring was carried out independently by the same two assessors that performed the MSUS examinations together with a third external observer who was an experienced histologist. All were blinded to the others’ evaluation and blinded to the results of the MSUS and the gross anatomy measurements. The same process was repeated after half an hour by each investigator to assess inter-and intra-observer reliability.
The histological characteristics of the muscle, the fat/fibrous infiltration and the organisation of muscular tissue were considered for semiquantitatively scoring of the muscles as follows: (1) normal, (2) moderate sarcopenia (moderate fat infiltration and fibrosis) and (3) severe sarcopenia (severe fat infiltration and fibrosis) (