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Quantification of early fatty infiltration of the rotator cuff muscles: comparison of multi-echo Dixon with single-voxel MR spectroscopy

  • Magnetic Resonance
  • Published:
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Abstract

Objectives

To evaluate quantification of early fatty infiltration in supraspinatus muscles with magnetic resonance (MR) imaging using a T2*-corrected multi-echo 3D-gradient-echo Dixon-based sequence (multi-echo Dixon) and compare it to proton-MR-spectroscopy.

Methods

Sixty subjects (mean age 46 years, 41 men) with good supraspinatus muscle quality on 1.5 T MR imaging were included. Fat percentage (FP) in the supraspinatus muscle was quantified using a multi-echo Dixon compared to single-voxel MR spectroscopy as reference standard. In 18 subjects the multi-echo Dixon was repeated to assess test-retest reliability. Measurements based on multi-echo Dixon were performed by two independent readers by placing regions-of-interest (ROIs) in the supraspinatus muscle corresponding to the MR-spectroscopy voxel. Intraclass and concordance correlation coefficients (ICC/CCC) were used for statistical analysis.

Results

Test-retest reliability was substantial for reader 1 (ICC = 0.757) and almost perfect for reader 2 (ICC = 0.873). Inter-reader reliability for multi-echo Dixon was almost perfect (ICC = 0.893, P < .0005). Mean FP in all 60 subjects with multi-echo Dixon was 3.5 ± 1.6 for reader 1, 3.7 ± 1.8 for reader 2, and 2.8 ± 1.4 with MR spectroscopy. Correlation between multi-echo Dixon and MR spectroscopy was moderate (CCC = 0.641).

Conclusion

The multi-echo Dixon sequence is a reliable method and comparable to MR-spectroscopy for quantification of low levels of fatty infiltration in the supraspinatus muscle.

Key Points

• Multi-echo Dixon for low fat quantification in muscles is reliable.

• Multi-echo Dixon low fat quantification is comparable to single-voxel MR spectroscopy

• Multi-echo Dixon detects substantial differences in fatty infiltration within Goutallier 0–1.

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Abbreviations

FP:

Fat percentage

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Acknowledgments

An oral abstract of this work was presented at ECR 2015. The scientific guarantor of this publication is Christoph Agten. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, performed at one institution.

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Authors and Affiliations

  1. Radiology, Balgrist University Hospital, Forchstrasse 340, CH-8008, Zurich, Switzerland

    Christoph A. Agten, Andrea B. Rosskopf & Christian W. A. Pfirrmann

  2. Orthopaedic Surgery, Balgrist University Hospital, Forchstrasse 340, CH-8008, Zurich, Switzerland

    Christian Gerber

  3. Faculty of Medicine, University of Zurich, Zurich, Switzerland

    Christoph A. Agten, Andrea B. Rosskopf, Christian Gerber & Christian W. A. Pfirrmann

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  1. Christoph A. Agten
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Correspondence to Christoph A. Agten.

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Agten, C.A., Rosskopf, A.B., Gerber, C. et al. Quantification of early fatty infiltration of the rotator cuff muscles: comparison of multi-echo Dixon with single-voxel MR spectroscopy. Eur Radiol 26, 3719–3727 (2016). https://doi.org/10.1007/s00330-015-4144-y

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