Department of Radiology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea.
Department of Neurology, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea.
J Cachexia Sarcopenia Muscle. 2019 Jun;10(3):574-585. doi: 10.1002/jcsm.12415. Epub 2019 Mar 15.
This study aimed to evaluate the potential value of 3D multiple gradient echo Dixon-based magnetic resonance imaging (MRI) sequence as a tool for thigh intramuscular fat quantification in Charcot-Marie-Tooth disease (CMT) patients.
A prospective comparison study comprising 18 CMT patients and 18 age/sex-matched volunteers was performed. MRI including 3D multiple gradient echo Dixon-based imaging was performed for each subject. Region of interest analyses were performed at the upper and lower third of both thighs. The two-sample t-test or Wilcoxon rank sum test was used for intergroup comparison of the mean muscle fat fraction. Intraclass correlation coefficients were used to evaluate the interobserver agreement and test-retest reproducibility. Semiquantitive analysis using the Goutallier classification (Grades 0-4) was performed on T1-weighted images in upper thigh muscles. For Goutallier Grade 0 muscles, comparison of the mean intramuscular fat fraction between volunteers and CMT patients was performed.
The interobserver agreements were excellent for all measurements (intraclass correlation coefficients > 0.8). Mean muscle fat fractions were significantly higher in all the measured muscles of CMT patients (P < 0.05) except in the adductor magnus in the upper thigh (P = 0.109). Goutallier Grade 0 muscles of the CMT patients showed a significantly higher mean fat fraction compared with that of the volunteers (P < 0.05).
3D multiple gradient echo Dixon-based MRI is a reproducible and sensitive technique which can reveal a significant difference in the fat fraction of thigh muscle, including comparison between Goutallier Grade 0 muscles, between CMT patients and volunteers.
本研究旨在评估 3D 多梯度回波 Dixon 磁共振成像（MRI）序列在评估腓骨肌萎缩症（CMT）患者大腿肌内脂肪定量中的潜在价值。
本前瞻性对比研究纳入 18 例 CMT 患者和 18 例年龄、性别匹配的志愿者。对每位受试者进行包括 3D 多梯度回波 Dixon 成像的 MRI 检查。在大腿的上下三分之一处进行感兴趣区域分析。使用两样本 t 检验或 Wilcoxon 秩和检验比较两组平均肌肉脂肪分数。采用组内相关系数评估观察者间的一致性和测试-再测试的可重复性。在上大腿肌肉的 T1 加权图像上进行 Goutallier 分级（0-4 级）半定量分析。对于 Goutallier Grade 0 肌肉，比较志愿者和 CMT 患者的平均肌内脂肪分数。
所有测量的观察者间一致性均为优（组内相关系数>0.8）。除了上大腿内收大肌（P=0.109）外，CMT 患者所有测量肌肉的平均肌肉脂肪分数均显著升高（P<0.05）。与志愿者相比，CMT 患者的 Goutallier Grade 0 肌肉的平均脂肪分数显著升高（P<0.05）。
3D 多梯度回波 Dixon 磁共振成像具有良好的可重复性和敏感性，可显示大腿肌肉脂肪分数的显著差异，包括 Goutallier Grade 0 肌肉之间、CMT 患者与志愿者之间的比较。
