Abstract
Objective
The goal of this study was to compare the semi-quantitative Goutallier classification for fat infiltration with quantitative fat-fraction derived from a magnetic resonance imaging (MRI) chemical shift-based water/fat separation technique.
Methods
Sixty-two women (age 61 ± 6 years), 27 of whom had diabetes, underwent MRI of the calf using a T1-weighted fast spin-echo sequence and a six-echo spoiled gradient-echo sequence at 3 T. Water/fat images and fat fraction maps were reconstructed using the IDEAL algorithm with T2* correction and a multi-peak model for the fat spectrum. Two radiologists scored fat infiltration on the T1-weighted images using the Goutallier classification in six muscle compartments. Spearman correlations between the Goutallier grades and the fat fraction were calculated; in addition, intra-observer and inter-observer agreement were calculated.
Results
A significant correlation between the clinical grading and the fat fraction values was found for all muscle compartments (P < 0.0001, R values ranging from 0.79 to 0.88). Goutallier grades 0–4 had a fat fraction ranging from 3.5 to 19%. Intra-observer and inter-observer agreement values of 0.83 and 0.81 were calculated for the semi-quantitative grading.
Conclusion
Semi-quantitative grading of intramuscular fat and quantitative fat fraction were significantly correlated and both techniques had excellent reproducibility. However, the clinical grading was found to overestimate muscle fat.
Key Points
• Fat infiltration of muscle commonly occurs in many metabolic and neuromuscular diseases.
• Image-based semi-quantitative classifications for assessing fat infiltration are not well validated.
• Quantitative MRI techniques provide an accurate assessment of muscle fat.
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Acknowledgements
This study was supported by the National Institutes of Health grants R01-AG17762 and RC1-AR058405.
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Alizai, H., Nardo, L., Karampinos, D.C. et al. Comparison of clinical semi-quantitative assessment of muscle fat infiltration with quantitative assessment using chemical shift-based water/fat separation in MR studies of the calf of post-menopausal women. Eur Radiol 22, 1592–1600 (2012). https://doi.org/10.1007/s00330-012-2404-7
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DOI: https://doi.org/10.1007/s00330-012-2404-7