The reproducibility of skeletal muscle signal intensity on routine magnetic resonance imaging in Crohn's disease

Abstract

Background and Aim Myosteatosis is a prognostic factor in cancer and liver cirrhosis. It can be determined noninvasively using computed tomography or, as shown recently, by magnetic resonance (MR) imaging. The primary aim was to analyze the reproducibility of skeletal muscle signal intensity on routine MR‐enterographies, as indicator of myosteatosis, in Crohn's disease (CD) and to explore the association between skeletal muscle signal intensity at diagnosis with time to intestinal resection. Methods CD patients undergoing MR‐enterography within 6 months from diagnosis and having a maximum of 5 years follow‐up were included. Skeletal muscle signal intensity was analyzed on T1‐weighted fat‐saturated post‐contrast images. Intra‐observer and inter‐observer reproducibilities were assessed by intra‐class correlation coefficient and Cohen's kappa. Intra‐observer and inter‐observer variabilities were determined by Pearson correlation coefficient and displayed by Bland–Altman plots. Time to intestinal resection was studied by Kaplan–Meier analysis. Results Median time between diagnosis and MR‐enterography was 5 weeks (inter‐quartile range 1–9) in 35 CD patients. Skeletal muscle signal intensity showed good intra‐class correlation and substantial agreement (for intra‐observer, intraclass correlation coefficient = 0.948, κ = 0.677; and inter‐observer reproducibility, intraclass correlation coefficient = 0.858, κ = 0.622). Resection free survival was shorter in the low skeletal muscle signal intensity group (P = 0.037). Conclusion Skeletal muscle signal intensity on routine MR‐enterographies is reproducible and was associated with unfavorable disease outcome, indicating potential clinical relevance.

Inflammatory Bowel Disease and Sarcopenia: Its Mechanism and Clinical Importance

“…Moreover, screening tools for sarcopenia such as SARC-F (a questionnaire consisting of five questions) as recommended by AWGS and EWGSOP, are not available in patients with IBD [ 4 , 5 , 33 ]. On the other hand, the usefulness of skeletal muscle signal intensity in magnetic resonance imaging (MRI) T1-weighted images for the clinical outcomes in patients with CD has also been reported [ 34 ]. It has been reported that muscle mass in MRI correlates well with lean body mass using a bioelectrical impedance analysis (BIA) method in pediatric patients with UC [ 35 ].…”

Impact of myopenia and myosteatosis on postoperative outcome and recurrence in Crohn’s disease

“…In the literature, there are only two known smaller scaled studies using different MRI sequences to assess myopenia or myosteatosis in patients with CD. Spooren et al [ 24 ] evaluated T1-weighted fat-saturated post-contrast images in 35 CD patients, while Celentano et al [ 25 ] assessed axial T2-weighted sequences in 31 CD patients. In these studies, myopenia and myosteatosis were associated with a higher rate of postoperative complications and unfavorable disease outcome, indicating potential clinical relevance for these two parameters [ 24 , 25 ].…”

“…Spooren et al [ 24 ] evaluated T1-weighted fat-saturated post-contrast images in 35 CD patients, while Celentano et al [ 25 ] assessed axial T2-weighted sequences in 31 CD patients. In these studies, myopenia and myosteatosis were associated with a higher rate of postoperative complications and unfavorable disease outcome, indicating potential clinical relevance for these two parameters [ 24 , 25 ]. In our cohort of 223 CD patients, we investigated the role of MRI-defined myopenia and myosteatosis with anastomotic leakage, postoperative complications, and recurrence rates based on a homogeneous cohort, including only patients with Crohn’s disease undergone ileocecal resection.…”

“…Myopenia, defined as the presence of clinically relevant muscle wasting due to any illness and at any age [19], and myosteatosis, the infiltration of fat in skeletal muscle, have been proposed to be prognostic factors of relevant clinical and socio-economic negative outcomes, such as poor surgical outcomes and survival rates for cancer patients [20][21][22][23]. However, their exact role in CD is unknown, since only limited data exists showing that myopenia and myosteatosis in CD patients were associated with a higher rate of postoperative complications and unfavorable disease outcome [24,25]. The aim of the present study was to assess the impact of MRI defined myopenia and myosteatosis on anastomotic leakage after ileocecal resection in patients with CD based on data of a high-volume center.…”

Impact of myopenia and myosteatosis on postoperative outcome and recurrence in Crohn’s disease

“…In the literature, there are only two known smaller scaled studies using different MRI sequences to assess myopenia or myosteatosis in patients with CD. Spooren et al [24] evaluated T1-weighted fatsaturated post-contrast images in 35 CD patients, while Celentano et al [25] assessed axial T2-weighted sequences in 31 CD patients. In these studies, myopenia and myosteatosis were associated with a higher rate of postoperative complications and unfavorable disease outcome, indicating potential clinical relevance for these two parameters [24,25].…”