MRI is the gold standard, better for visualisation of any underlying compressive radiculopathies and any associated muscle inflamation. Underlying pathology may require additional sequences including but not limiyed to post gadolinium (IV contrast) sequences.
The gold standard measure for determining whether a muscle has a hypertrophic response is typically MRI (Magnetic Resonance Imaging).
MRI provides highly detailed and accurate measurements of muscle size, cross-sectional area, and volume, making it the most reliable imaging modality for assessing muscle hypertrophy. While CT (Computed Tomography) and B-Mode Ultrasonography can also measure muscle size, they have limitations in comparison to MRI:
• CT is limited by its exposure to ionizing radiation and lower soft tissue contrast compared to MRI.
• B-Mode Ultrasonography is a useful, non-invasive, and cost-effective tool but is operator-dependent and less precise for measuring deeper muscles or total muscle volume.
Thus, MRI is the preferred method when the most accurate and reliable measurement of muscle hypertrophy is required.