Quantification of Muscle Fat in Patients with Low Back Pain: Comparison of Multi-Echo MR Imaging with Single-Voxel MR Spectroscopy

Abstract

Large-volume image-based (dual-echo and multi-echo MR imaging) and spectroscopic fat-signal fractions agree well, thus allowing fast and accurate quantification of muscle fat content in patients with low back pain.

Age- and Level-Dependence of Fatty Infiltration in Lumbar Paravertebral Muscles of Healthy Volunteers

“…Additionally, 2-point Dixon sequences are prone to underestimating FSF; however, we limited the influence by reduction of the flip angle. 5 Our healthy volunteers evidenced declining muscle quality as a normal process of aging from the twenties into mature adulthood. Investigating whether serial decline continues into healthy older adulthood would be valuable.…”

“…10,11 Excellent accuracy for MFI quantification is shown in comparison with T1WI, 12 spectroscopy, 5 and histology in different animal species. 9 Accordingly, Dixon MR imaging was used for evaluating muscle fat content in several clinical studies including patients with low back pain (LBP), 5,13 acute-to-chronic whiplash, 14 and neuromuscular disorders. 15 Quantification of degeneration (fat infiltration and atrophy) of lumbar paravertebral muscles has attracted interest in understanding their biologic influence on persistent LBP.…”

“…Little is known about normative degeneration, and comparisons with existing literature are limited. Using similar quantification methods with axial 2-point Dixon MR imaging at 1.5T, Fischer et al 5 described mean FSF within a region of bilateral multifidus muscles of 21% (range, 3%-65%). Despite their reporting symptomatic cases (potentially higher MFI percentage), our results (for MF / MF ϩ ES) of 23%/ 18% in female and 18%/15% in male lumbar paravertebral muscles appear aligned and may reflect consistent methods.…”

“…1,2 While T1WI is commonly used for qualitative assessment of muscle fat infiltration (MFI), 3,4 chemical-shift-based imaging sequences allow quantification, [5][6][7] which correlates with clinical symptoms 3,8 and histology.…”

Magnetic resonance spectroscopic analysis of multifidus muscles lipid content and association with spinopelvic malalignment in chronic low back pain

“…MRI is useful for analyzing fat degeneration of the Mm. [10][11][12] Recently, in addition to morphological assessments, muscles have been evaluated using MRI with the multipoint Dixon technique 12,13 and MR spectroscopy (MRS). 10,14 MRS analysis of muscle physiology has been used in various fields, such as sports medicine, [15][16][17] and has facilitated detailed analyses of muscular fat masses by recording the presence of intramyocellular lipids (IMCLs) and extramyocellular lipids (EMCLs); this has helped to identify detail of fatty degeneration.…”