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Quantitative multi-parameter assessment of age- and gender-related variation of back extensor muscles in healthy adults using Dixon MR imaging

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

Investigate sex differences in age-related back extensor muscle degeneration using Dixon MRI and analyze the relationship between quantitative muscle parameters and back muscle strength in healthy adults.

Methods

105 healthy subjects underwent lumbar Dixon MRI. Fat fraction (FF), cross-sectional area (CSA), functional CSA (FCSA), and relative FCSA (RFCSA) of multifidus muscle (MF) and erector spinae (ES) were quantified. Back extension muscle strength was measured using an external fixation dynamometer. ANOVA with post hoc Tukey correction was used for age group comparisons. Partial and Spearman’s correlation analyzed relationships between age, muscle parameters, and muscle strength.

Results

MF and ES FF significantly increased with age in both genders (r = 0.55–0.85; p < 0.001). Muscle FF increased prominently for females (40–49 years, MF and 50–59 years, ES) and males (60–73 years, MF and ES). In females, total ES FCSA and RFCSA (r =  − 0.42, − 0.37; p < 0.01) correlated with age. While in males, all MF and ES muscle size parameters, except total MF CSA, correlated with age (r =  − 0.30 to − 0.58; p < 0.05). Back extension muscle strength correlated with mean FF, total CSA, and total FCAS for MF and ES individually (p < 0.001). The combined MF + ES FCSA correlation coefficient (r = 0.63) was higher than FF (r =  − 0.51) and CSA (r = 0.59) (p < 0.001).

Conclusions

Age-related back extensor muscle degeneration varies by muscle type and sex. FCSA has the highest association with back muscle strength compared to FF and CSA.

Clinical relevance statement

The investigation of sex differences in age-related back extensor muscle degeneration utilizing Dixon imaging may hold significant implications for evaluating spine health and enabling earlier intervention. Muscles’ FCSA could contribute to acquiring additional evidence for reflecting muscle function change.

Key Points

• The multifidus muscle (MF) and erector spinae (ES) fat fraction (FF) increased with age at all lumbar disc levels in females and males.

• Age-related changes in muscle morphological quantitative parameters of healthy adults were specific by muscle type and gender.

• The muscle functional cross-sectional area (FCSA) measured by Dixon imaging may better monitor back extensor muscle strength changes than muscle FF and cross-sectional area (CSA).

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Abbreviations

BMI:

Body mass index

CSA:

Cross-sectional area

ES:

Erector spinae

FCSA:

Functional cross-sectional area

FF:

Fat fraction

FI:

Fat infiltration

MF:

Multifidus muscle

MVIC:

Maximum voluntary isometric contraction

RCSA:

Relative cross-sectional area

RFCSA:

Relative functional cross-sectional area

TSE:

Turbo spin echo

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Acknowledgements

The authors thank Hui Lin, for their helpful advice on the statistical analysis.

Funding

This study has received funding from Chongqing Science and Technology Commission, China (No. cstc2019jscx-msxmX0221).

Author information

Author notes

  1. Pinzhen Chen and Zhou Zhou contributed equally to this work and should be considered co-first authors.

  2. Jun Zhao and Wei Chen contributed equally as co-corresponding authors.

Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital, Army Medical University, 30 Gaotanyan Street Shapingba District, Chongqing, 400038, China

    Pinzhen Chen, Zhou Zhou, Jin Li, Min He, Jun Zhao & Wei Chen

  2. Health Management Center, The First Affiliated Hospital, Army Medical University, Chongqing, 400038, China

    Li Sun

  3. Department of Orthopedics, The First Affiliated Hospital, Army Medical University, Chongqing, 400038, China

    Xueke Yu, Kai Li & Fei Luo

  4. MR Collaboration NEA, Siemens Healthcare Ltd, Shanghai, 201318, China

    Xiaoyue Zhou

Authors
  1. Pinzhen Chen
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Corresponding authors

Correspondence to Jun Zhao or Wei Chen.

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Guarantor

The scientific guarantor of this publication is Dr. Wei Chen (Department of Radiology, The first affiliated hospital, Army Medical University).

Conflict of interest

Xiaoyue Zhou is an employee of Siemens Healthcare. The remaining authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

Hui Lin (Department of Epidemiology, College of Preventive Medicine, Third Military Medical University) kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects in this study.

Ethical approval

Institutional Review Board approval was obtained (No: (A) KY2021059).

Study subjects or cohorts overlap

Study subjects or cohorts have not been previously reported.

Methodology

• Prospective

• Cross-sectional study

• Performed at one institution

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Chen, P., Zhou, Z., Sun, L. et al. Quantitative multi-parameter assessment of age- and gender-related variation of back extensor muscles in healthy adults using Dixon MR imaging. Eur Radiol 34, 69–79 (2024). https://doi.org/10.1007/s00330-023-09954-w

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