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. 2008 Feb;26(2):188-97.
doi: 10.1016/j.mri.2007.06.006. Epub 2007 Aug 2.

Technical evaluation of in vivo abdominal fat and IMCL quantification using MRI and MRSI at 3 T

Xiaojuan Li  1 , Jack F Youngren, Ben Hyun, Giorgos K Sakkas, Kathleen Mulligan, Sharmila Majumdar, Umesh B Masharani, Morris Schambelan, Ira D Goldfine
Affiliations

Technical evaluation of in vivo abdominal fat and IMCL quantification using MRI and MRSI at 3 T

Xiaojuan Li et al. Magn Reson Imaging. 2008 Feb.

Abstract

Objectives: The objectives of this study were to develop protocols that measure abdominal fat and calf muscle lipids with magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS), respectively, at 3 T and to examine the correlation between these parameters and insulin sensitivity.

Materials and methods: Ten nondiabetic subjects [five insulin-sensitive (IS) subjects and five insulin-resistant (IR) subjects] were scanned at 3 T. Visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were segmented semiautomatically from abdominal imaging. Intramyocellular lipids (IMCL) in calf muscles were quantified with single-voxel MRS in both soleus and tibialis anterior muscles and with magnetic resonance spectroscopic imaging (MRSI).

Results: The average coefficient of variation (CV) of VAT/(VAT+SAT) was 5.2%. The interoperator CV was 1.1% and 5.3% for SAT and VAT estimates, respectively. The CV of IMCL was 13.7% in soleus, 11.9% in tibialis anterior and 2.9% with MRSI. IMCL based on MRSI (3.8+/-1.2%) were significantly inversely correlated with glucose disposal rate, as measured by a hyperinsulinemic-euglycemic clamp. VAT volume correlated significantly with IMCL. IMCL based on MRSI for IR subjects was significantly greater than that for IS subjects (4.5+/-0.9% vs. 2.8+/-0.5%, P=.02).

Conclusion: MRI and MRS techniques provide a robust noninvasive measurement of abdominal fat and muscle IMCL, which are correlated with insulin action in humans.

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Figures

Figure 1
Figure 1
Prescription of MR spectroscopy in calf muscles. a: Single voxel MRS in soleus (yellow) and in tibialis anterior (green) respectively; b: 2D MR spectroscopic imaging in calf muscles. Spatial saturation bands are shown as the yellow bands to suppress signals from subcutaneous fat, blood vessels and bone/bone marrows as much as possible.
Figure 2
Figure 2
Semi-automatic segmentation for abdominal fat tissues using a single-slice T1-weighted image between L4–L5. a: The original image with a T1-weighted fast spin-echo (FSE) water suppressed sequence between L4–L5; b: The image after coil correction; c: The histogram of the image in b. The threshold was selected as the minimum value between the low intensity first peak, representing the muscle and background pixel intensities, and the higher intensity peak, representing the fat pixel intensities; d: Fat segmentation based on the threshold in c, with outside contour as subcutaneous adipose tissue (SAT) and inner contour as visceral adipose tissue (VAT).
Figure 3
Figure 3
MR spectroscopy of calf muscles. Upper row: Single voxel MRS in soleus (b) and in tibialis anterior (c) respectively; lower row: 2D MR spectroscopic imaging. Water (4.7 ppm), creatine (Cr2 at 3.95ppm, Cr3 at 3.05ppm), tri-methyl-ammonium (TMA, ~3.2ppm), EMCL (~1.5ppm) and IMCL (1.28 ppm) were quantified from both SV and MRSI data. Spectra showed good splitting between IMCL and EMCL peaks.
Figure 4
Figure 4
Abdominal images for an insulin sensitive (IS) subject (a, female, 28, 166 cm, 58 kg) and an insulin resistant (IR) subject (b, female, 33, 164 cm, 67 kg) respectively. Larger volume of visceral fat was observed in the IR subject than that in the IS subject (100.57 cm3 vs. 53.18 cm3).
Figure 5
Figure 5
IMCL quantified with 2D MRSI inversely correlated with the rate of glucose disposal per kg body weight (MBW, a) and per kg lean tissue (MLBM, b) significantly.
Figure 6
Figure 6
IMCL with single voxel in soleus (a) and with 2D MRSI (b) correlated with VAT volume significantly.
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