Schlaeger Sarah, Klupp Elisabeth, Weidlich Dominik, Cervantes Barbara, Foreman Sarah C, Deschauer Marcus, Schoser Benedikt, Katemann Christoph, Kooijman Hendrik, Rummeny Ernst J, Zimmer Claus, Kirschke Jan S, Karampinos Dimitrios C
From the Departments of Diagnostic and Interventional Neuroradiology.
Diagnostic and Interventional Radiology, and.
J Comput Assist Tomogr. 2018 Jul/Aug;42(4):574-579. doi: 10.1097/RCT.0000000000000723.
The assessment of fatty infiltration and edema in the musculature of patients with neuromuscular diseases (NMDs) typically requires the separate performance of T1-weighted and fat-suppressed T2-weighted sequences. T2-weighted Dixon turbo spin echo (TSE) enables the generation of T2-weighted fat- and water-separated images, which can be used to assess both pathologies simultaneously. The present study examines the diagnostic performance of T2-weighted Dixon TSE compared with the standard sequences in 10 patients with NMDs and 10 healthy subjects.
Whole-body magnetic resonance imaging was performed including T1-weighted Dixon fast field echo, T2-weighted short-tau inversion recovery, and T2-weighted Dixon TSE. Fatty infiltration and intramuscular edema were rated by 2 radiologists using visual semiquantitative rating scales. To assess intermethod and interrater agreement, weighted Cohen's κ coefficients were calculated.
The ratings of fatty infiltration showed high intermethod and high interrater agreement (T1-weighted Dixon fast field echo vs T2-weighted Dixon TSE fat image). The evaluation of edematous changes showed high intermethod and good interrater agreement (T2-weighted short-tau inversion recovery vs T2-weighted Dixon TSE water image).
T2-weighted Dixon TSE imaging is an alternative for accelerated simultaneous grading of whole-body skeletal muscle fat infiltration and edema in patients with NMDs.
评估神经肌肉疾病（NMD）患者肌肉组织中的脂肪浸润和水肿，通常需要分别进行T1加权和脂肪抑制T2加权序列检查。T2加权狄克逊快速自旋回波（TSE）能够生成T2加权的脂肪和水分离图像，可用于同时评估这两种病变。本研究在10例NMD患者和10名健康受试者中，将T2加权狄克逊TSE与标准序列的诊断性能进行了比较。
进行全身磁共振成像，包括T1加权狄克逊快速场回波、T2加权短反转时间反转恢复序列以及T2加权狄克逊TSE序列。由2名放射科医生使用视觉半定量评分量表对脂肪浸润和肌肉内水肿进行评分。为评估方法间和评分者间的一致性，计算加权科恩κ系数。
脂肪浸润评分显示出较高的方法间一致性和评分者间一致性（T1加权狄克逊快速场回波与T2加权狄克逊TSE脂肪图像）。水肿变化评估显示出较高的方法间一致性和良好的评分者间一致性（T2加权短反转时间反转恢复序列与T2加权狄克逊TSE水图像）。
T2加权狄克逊TSE成像可作为一种替代方法，用于对NMD患者全身骨骼肌脂肪浸润和水肿进行加速同步分级。
