Four functional magnetic resonance imaging techniques for skeletal muscle exploration, a systematic review

Abstract

Background: The study of muscle health has become more relevant lately, due to global aging and a higher incidence of musculoskeletal pathologies. Current exploration techniques, such as electromyography, do not provide accurate spatial information.

Objective: The objective of this work is to perform a systematic review of the literature to synthesize the contributions that can offer functional MRI techniques commonly used in neuroimaging, applied to skeletal muscle: Blood Oxygen Level Dependent (BOLD), IntraVoxel Incoherent Motion (IVIM), Arterial Spin Labeling (ASL) and Dynamic Contrast Enhanced (DCE).

Evidence acquisition: Web of Science and Medline databases were searched, over the last 10 years, focused on the use of BOLD, ASL, IVIM or DCE in skeletal muscle.

Evidence synthesis: 59 articles were included after applying the selection criteria. 37 studies were performed in healthy subjects, and 22 in patients with different pathologies: in peripheral arterial disease, systemic sclerosis, diabetes, osteoporosis, adolescent idiopathic scoliosis, and dermatomyositis. Reference values in healthy subjects still vary in some cases.

Conclusion: The studies show the feasibility of implementing functional MRI through BOLD, ASL, IVIM or DCE imaging in several muscles and their possible utility in different pathologies. A synthesis of how to implement such exploration is given here.

Clinical impact: These four techniques are based on sequences already present in clinical MRI scanners, therefore, their use for functional muscle exploration does not require additional investment. These techniques allow visualization and quantification of parameters associated with the vascular health of the muscles and represent interesting support for musculoskeletal exploration.

Keywords: ASL; BOLD; DCE; Functional MRI; IVIM; Skeletal muscle.