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Comparative Study
. 2012 Jul;22(7):1592-600.
doi: 10.1007/s00330-012-2404-7. Epub 2012 Mar 13.

Comparison of clinical semi-quantitative assessment of muscle fat infiltration with quantitative assessment using chemical shift-based water/fat separation in MR studies of the calf of post-menopausal women

Hamza Alizai  1 , Lorenzo Nardo, Dimitrios C Karampinos, Gabby B Joseph, Samuel P Yap, Thomas Baum, Roland Krug, Sharmila Majumdar, Thomas M Link
Affiliations
Comparative Study

Comparison of clinical semi-quantitative assessment of muscle fat infiltration with quantitative assessment using chemical shift-based water/fat separation in MR studies of the calf of post-menopausal women

Hamza Alizai et al. Eur Radiol. 2012 Jul.

Abstract

Objective: The goal of this study was to compare the semi-quantitative Goutallier classification for fat infiltration with quantitative fat-fraction derived from a magnetic resonance imaging (MRI) chemical shift-based water/fat separation technique.

Methods: Sixty-two women (age 61 ± 6 years), 27 of whom had diabetes, underwent MRI of the calf using a T1-weighted fast spin-echo sequence and a six-echo spoiled gradient-echo sequence at 3 T. Water/fat images and fat fraction maps were reconstructed using the IDEAL algorithm with T2* correction and a multi-peak model for the fat spectrum. Two radiologists scored fat infiltration on the T1-weighted images using the Goutallier classification in six muscle compartments. Spearman correlations between the Goutallier grades and the fat fraction were calculated; in addition, intra-observer and inter-observer agreement were calculated.

Results: A significant correlation between the clinical grading and the fat fraction values was found for all muscle compartments (P < 0.0001, R values ranging from 0.79 to 0.88). Goutallier grades 0-4 had a fat fraction ranging from 3.5 to 19%. Intra-observer and inter-observer agreement values of 0.83 and 0.81 were calculated for the semi-quantitative grading.

Conclusion: Semi-quantitative grading of intramuscular fat and quantitative fat fraction were significantly correlated and both techniques had excellent reproducibility. However, the clinical grading was found to overestimate muscle fat.

Key points: Fat infiltration of muscle commonly occurs in many metabolic and neuromuscular diseases. • Image-based semi-quantitative classifications for assessing fat infiltration are not well validated. • Quantitative MRI techniques provide an accurate assessment of muscle fat.

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Figures

Fig 1
Fig 1
T2-weighted image of the calf illustrating the manual segmentation of the six muscle compartments of the calf. AC anterior compartment, SOL soleus, DP deep posterior compartment, MG medial gastrocnemius, LG lateral gastrocnemius and LC lateral compartment
Fig 2
Fig 2
Representative water/fat separation MR images for the Goutallier classification 0–4 in the medial gastrocnemius muscle: T1-weighted image, water separated image, fat-separated image and fat fraction map. Grey scale corresponds to fat fraction values as percentages
Fig 3
Fig 3
Frequency of different Goutallier grades in the six muscle compartments in the whole calf averaged and in the individual compartments
Fig 4
Fig 4
Mean fat fraction in the distal calf according to the Goutallier classification averaged for all compartments and for the individual compartments
See this image and copyright information in PMC

References

    1. Wren TA, Bluml S, Tseng-Ong L, Gilsanz V. Three-point technique of fat quantification of muscle tissue as a marker of disease progression in Duchenne muscular dystrophy: preliminary study. AJR Am J Roentgenol. 2008;190:W8–W12. - PubMed
    1. Cheung S, Dillon E, Tham SC, et al. The presence of fatty infiltration in the infraspinatus: its relation with the condition of the supraspinatus tendon. Arthroscopy. 2011;27:463–470. - PubMed
    1. Hilton TN, Tuttle LJ, Bohnert KL, Mueller MJ, Sinacore DR. Excessive adipose tissue infiltration in skeletal muscle in individuals with obesity, diabetes mellitus, and peripheral neuropathy: association with performance and function. Phys Ther. 2008;88:1336–1344. - PMC - PubMed
    1. Andersen H, Gadeberg PC, Brock B, Jakobsen J. Muscular atrophy in diabetic neuropathy: a stereological magnetic resonance imaging study. Diabetologia. 1997;40:1062–1069. - PubMed
    1. Andersen H, Nielsen S, Mogensen CE, Jakobsen J. Muscle strength in type 2 diabetes. Diabetes. 2004;53:1543–1548. - PubMed

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