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Marth AA, Spinner GR, von Deuster C, Sommer S, Sutter R, Nanz D. Activation patterns of rotator-cuff muscles from quantitative IVIM DWI after physical testing. Eur Radiol Exp 2024; 8:96. [PMID: 39186226 PMCID: PMC11347545 DOI: 10.1186/s41747-024-00487-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/18/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND The diagnostic value of clinical rotator cuff (RC) tests is controversial, with only sparse evidence available about their anatomical specificity. We prospectively assessed regional RC muscle activation patterns by means of intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (MRI) after the execution of common clinical RC tests. METHODS Ten healthy subjects (five males, five females) underwent three sessions of diffusion-weighted 3-T shoulder MRI before and after testing the supraspinatus (SSP, Jobe test, session 1), subscapularis (SSC, lift-off test, session 2, at least 1 week later), and infraspinatus muscle (ISP, external rotation test, session 3, another week later). IVIM parameters (perfusion fraction, f; pseudo-diffusion coefficient. D*; and their product, fD*) were measured in regions of interest placed in images of the SSP, SSC, ISP, and deltoid muscle. The Wilcoxon signed-rank test was used for group comparisons; p-values were adjusted using the Bonferroni correction. RESULTS After all tests, fD* was significantly increased in the respective target muscles (SSP, SSC, or ISP; p ≤ 0.001). After SSP testing, an additional significant increase of fD* was observed in the deltoid, the SSC, and the ISP muscle (p < 0.001). After the SSC and ISP tests, no significant concomitant increase of any parameter was observed in the other RC muscles. CONCLUSION IVIM revealed varying activation patterns of RC muscles for different clinical RC tests. For SSP testing, coactivation of the deltoid and other RC muscles was observed, implying limited anatomical specificity, while the tests for the SSC and ISP specifically activated their respective target muscle. RELEVANCE STATEMENT Following clinical RC tests, IVIM MRI revealed that SSP testing led to shoulder muscle coactivation, while the SSC and ISP tests specifically activated the target muscles. KEY POINTS In this study, intravoxel incoherent motion MRI depicted muscle activation following clinical rotator cuff tests. After supraspinatus testing, coactivation of surrounding shoulder girdle muscles was observed. Subscapularis and infraspinatus tests exhibited isolated activation of their respective target muscles.
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Affiliation(s)
- Adrian Alexander Marth
- Swiss Center for Musculoskeletal Imaging (SCMI), Balgrist Campus AG, Zurich, Switzerland.
- Department of Radiology, Balgrist University Hospital, Zurich, Switzerland.
| | - Georg Ralph Spinner
- Center of Computational Health, Institute of Computational Life Sciences, University of Applied Sciences (ZHAW), Wädenswil, Switzerland
| | - Constantin von Deuster
- Swiss Center for Musculoskeletal Imaging (SCMI), Balgrist Campus AG, Zurich, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Zurich, Switzerland
| | - Stefan Sommer
- Swiss Center for Musculoskeletal Imaging (SCMI), Balgrist Campus AG, Zurich, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Zurich, Switzerland
| | - Reto Sutter
- Department of Radiology, Balgrist University Hospital, Zurich, Switzerland
- Medical Faculty, University of Zurich (UZH), Zurich, Switzerland
| | - Daniel Nanz
- Swiss Center for Musculoskeletal Imaging (SCMI), Balgrist Campus AG, Zurich, Switzerland
- Medical Faculty, University of Zurich (UZH), Zurich, Switzerland
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Bisgaard M, Houlind KC, Blankholm AD, Ringgaard S, Christensen J, Precht H. Validation of MRI assessment of foot perfusion for improving treatment of patients with peripheral artery disease. Radiography (Lond) 2024; 30:1116-1124. [PMID: 38797044 DOI: 10.1016/j.radi.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION Information on tissue perfusion in the foot is important when treating patients with chronic limb-threatening ischemia. This study aims to test the reliability of different magnetic resonance sequences when measuring perfusion in the foot. METHODS Sixteen healthy volunteers had their right foot scanned in a test/retest study with six different magnetic resonance sequences (BOLD, multi-echo gradient echo (mGRE), 2D and 3D pCASL, PASL FAIR, and DWI with intravoxel incoherent motion (IVIM) with quantitative measurements of perfusion. For five sequences, cuff-induced ischemia followed by a hyperactive response was measured. Images of the feet were segmented into angiosomes and perfusion data were extracted from the five angiosomes. RESULTS BOLD, PASL FAIR, mGRE, and DWI with IVIM had low mean differences between the first and second scans, while the results of 2D and 3D pCASL had the highest differences. Based on a paired t-test, BOLD, and FAIR were able to distinguish between perfusion and no perfusion in all angiosomes with p-values below 0.01. This was not the case with 2D and 3D pCASL with p-values above 0.05 in all angiosomes. The mGRE could not distinguish between perfusion and no perfusion in the lateral side of the foot. CONCLUSION BOLD, mGRE, pASL FAIR, and DWI with IVIM seem to give more robust results compared to 2D and 3D pCASL. Further studies on patients with peripheral artery disease should explore if the sequences can have clinical relevance when assessing tissue ischemia and results of revascularization. IMPLICATIONS FOR PRACTICE This study provides knowledge that could be used to improve the diagnosis of patient with chronic limb-threatening ischemia to explore tissue perfusion.
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Affiliation(s)
- M Bisgaard
- Department of Radiology, Kolding Hospital, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Health Sciences Research Centre, UCL University College, Odense M, Denmark.
| | - K C Houlind
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Vascular Surgery, Kolding Hospital, Kolding, Denmark.
| | - A D Blankholm
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
| | - S Ringgaard
- MR Research Center, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - J Christensen
- Department of Radiology, Kolding Hospital, Kolding, Denmark.
| | - H Precht
- Department of Radiology, Kolding Hospital, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Health Sciences Research Centre, UCL University College, Odense M, Denmark.
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Li J, Lu Z, Yuan L, Wang Q, Zhu J, Bao D, Grimm R, Wang X, Wang X, Xue H, Jin Z. Intravoxel incoherent motion imaging to assess the acute effects of moderate-intensity continuous training and high-intensity interval training on thigh muscles. NMR IN BIOMEDICINE 2024; 37:e5045. [PMID: 37852945 DOI: 10.1002/nbm.5045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 08/18/2023] [Accepted: 09/02/2023] [Indexed: 10/20/2023]
Abstract
This study investigated the use of intravoxel incoherent motion imaging (IVIM) to compare skeletal muscle perfusion during and after high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) to determine the impact on fat oxidation outcomes. Twenty overweight volunteers were recruited for the study. Each participant received one HIIT intervention and one MICT intervention using a cycling ergometer. Participants underwent a magnetic resonance imaging scan before, immediately after, and 1 and 2 h after each intervention. The IVIM parameters (D, fD*) of the rectus femoris, vastus lateralis, and biceps femoris long head were obtained. Changes in IVIM parameters of these muscles after both exercise interventions were compared using a two-factor repeated measures analysis of variance. In the rectus femoris, the fD* increased immediately after exercise intervention (d = 0.69 × 10-3 mm2 /s, p < 0.0083) and 2 h after exercise intervention (d = 0.64 × 10-3 mm2 /s, p < 0.0083) compared with before exercise. The increase in the fD* in the HIIT group was greater than that in the MICT group (d = 0.32, p = 0.023). In the vastus lateralis, the fD* increased immediately after the exercise intervention (d = 0.53 × 10-3 mm2 /s, p < 0.001) and returned to the pre-exercise level 1 h after exercising. The increase in the fD* in the HIIT group was lower than that in the MICT group (d = -0.21, p = 0.015). For the biceps femoris long head, the fD* was not significantly different between the two exercise interventions before and after exercise. Furthermore, the fD* 60 min after the HIIT intervention correlated with maximal oxygen consumption (VO2max), whereas fD* immediately after the MICT intervention correlated with VO2max. In summary, IVIM parameters can be used to evaluate differences in muscle perfusion between HIIT and MICT, and show a correlation with VO2max.
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Affiliation(s)
- Jiao Li
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijiing, China
| | - Zepeng Lu
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Ling Yuan
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijiing, China
| | - Qin Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijiing, China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthineers Ltd, Erlangen, Germany
| | - Dapeng Bao
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Robert Grimm
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Xiao Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijiing, China
| | - Xiaoye Wang
- MR Clinical Marketing, Siemens Healthineers Ltd, Erlangen, Germany
| | - Huadan Xue
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijiing, China
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijiing, China
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Nai YH, Wang X, Gan J, Lian CPL, Kirwan RF, Tan FSL, Hausenloy DJ. Effects of fitting methods, high b-values and image quality on diffusion and perfusion quantification and reproducibility in the calf. Comput Biol Med 2023; 157:106746. [PMID: 36924736 DOI: 10.1016/j.compbiomed.2023.106746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/17/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023]
Abstract
PURPOSES The study aimed to optimize diffusion-weighted imaging (DWI) image acquisition and analysis protocols in calf muscles by investigating the effects of different model-fitting methods, image quality, and use of high b-value and constraints on parameters of interest (POIs). The optimized modeling methods were used to select the optimal combinations of b-values, which will allow shorter acquisition time while achieving the same reliability as that obtained using 16 b-values. METHODS Test-retest baseline and high-quality DWI images of ten healthy volunteers were acquired on a 3T MR scanner, using 16 b-values, including a high b-value of 1200 s/mm2, and structural T1-weighted images for calf muscle delineation. Three and six different fitting methods were used to derive ADC from monoexponential (ME) model and Dd, fp, and Dp from intravoxel incoherent motion (IVIM) model, with or without the high b-value. The optimized ME and IVIM models were then used to determine the optimal combinations of b-values, obtainable with the least number of b-values, using the selection criteria of coefficient of variance (CV) ≤10% for all POIs. RESULTS The find minimum multivariate algorithm was more flexible and yielded smaller fitting errors. The 2-steps fitting method, with fixed Dd, performed the best for IVIM model. The inclusion of high b-value reduced outliers, while constraints improved 2-steps fitting only. CONCLUSIONS The optimal numbers of b-values for ME and IVIM models were nine and six b-values respectively. Test-retest reliability analyses showed that only ADC and Dd were reliable for calf diffusion evaluation, with CVs of 7.22% and 4.09%.
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Affiliation(s)
- Ying-Hwey Nai
- Clinical Imaging Research Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Xiaomeng Wang
- Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore
| | | | - Cheryl Pei Ling Lian
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Ryan Fraser Kirwan
- Infocomm Technology Cluster, Singapore Institute of Technology, Singapore
| | - Forest Su Lim Tan
- Infocomm Technology Cluster, Singapore Institute of Technology, Singapore
| | - Derek J Hausenloy
- Cardiovascular & Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore; National Heart Research Institute Singapore, National Heart Centre, Singapore; Yong Loo Lin School of Medicine, National University Singapore, Singapore; The Hatter Cardiovascular Institute, University College London, London, UK
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Evaluation of apparent diffusion coefficient of two-dimensional BLADE turbo gradient- and spin-echo diffusion-weighted imaging with a breast phantom. Radiol Phys Technol 2023; 16:118-126. [PMID: 36596917 DOI: 10.1007/s12194-022-00694-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023]
Abstract
This study aimed to evaluate the reliability of apparent diffusion coefficient (ADC) values generated with two-dimensional turbo gradient- and spin-echo with BLADE trajectory diffusion-weighted imaging (TGSE-BLADE-DWI) sequence using a breast diffusion phantom. TGSE-BLADE-DWI and single-shot spin-echo echo-planar imaging (SS-EPI-DWI) were performed using a 3.0 T magnetic resonance imaging scanner. Concordance rates of ADC values and the signal-to-noise ratio (SNR) were compared between TGSE-BLADE-DWI and SS-EPI-DWI. TGSE-BLADE-DWI provided a higher concordance rate for ADC values than SS-EPI-DWI when b-values > 2000s/mm2 and a slice thickness of 1 mm were used. TGSE-BLADE-DWI showed less image distortion than SS-EPI-DWI. The SNR of TGSE-BLADE-DWI was higher than that of SS-EPI-DWI, except at a number of excitations of 7 and a slice thickness of 1 mm. In conclusion, TGSE-BLADE-DWI can offer a better SNR, less distortion, and more reliable ADC measurements than SS-EPI-DWI in a breast phantom.
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Veeger TTJ, Hirschler L, Baligand C, Franklin SL, Webb AG, de Groot JH, van Osch MJP, Kan HE. Microvascular response to exercise varies along the length of the tibialis anterior muscle. NMR IN BIOMEDICINE 2022; 35:e4796. [PMID: 35778859 PMCID: PMC9787660 DOI: 10.1002/nbm.4796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 06/10/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
Microvascular function is an important component in the physiology of muscle. One of the major parameters, blood perfusion, can be measured noninvasively and quantitatively by arterial spin labeling (ASL) MRI. Most studies using ASL in muscle have only reported data from a single slice, thereby assuming that muscle perfusion is homogeneous within muscle, whereas recent literature has reported proximodistal differences in oxidative capacity and perfusion. Here, we acquired pulsed ASL data in 12 healthy volunteers after dorsiflexion exercise in two slices separated distally by 7 cm. We combined this with a Look-Locker scheme to acquire images at multiple postlabeling delays (PLDs) and with a multiecho readout to measure T2 *. This enabled the simultaneous evaluation of quantitative muscle blood flow (MBF), arterial transit time (ATT), and T2 * relaxation time in the tibialis anterior muscle during recovery. Using repeated measures analyses of variance we tested the effect of time, slice location, and their interaction on MBF, ATT, and T2 *. Our results showed a significant difference as a function of time postexercise for all three parameters (MBF: F = 34.0, p < .0001; T2 *: F = 73.7, p < .0001; ATT: F = 13.6, p < .001) and no average differences between slices over the total time postexercise were observed. The interaction effect between time postexercise and slice location was significant for MBF and T2 * (F = 5.5, p = 0.02, F = 6.1, p = 0.02, respectively), but not for ATT (F = 2.2, p = .16). The proximal slice showed a higher MBF and a lower ATT than the distal slice during the first 2 min of recovery, and T2 * showed a delayed response in the distal slice. These results imply a higher perfusion and faster microvascular response to exercise in the proximal slice, in line with previous literature. Moreover, the differences in ATT indicate that it is difficult to correctly determine perfusion based on a single PLD as is commonly performed in the muscle literature.
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Affiliation(s)
- Thom T. J. Veeger
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
| | - Lydiane Hirschler
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
| | - Celine Baligand
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
- CEA, CNRS, MIRCen, Laboratoire des Maladies NeurodégénérativesUniversité Paris‐SaclayFontenay‐aux‐RosesFrance
| | - Suzanne L. Franklin
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
- Center for Image SciencesUniversity Medical Centre UtrechtUtrechtthe Netherlands
| | - Andrew G. Webb
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
| | | | - Matthias J. P. van Osch
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
- Leiden Institute for Brain and CognitionLeiden UniversityLeidenthe Netherlands
| | - Hermien E. Kan
- C. J. Gorter MRI Center, Dept. of RadiologyLeiden University Medical Center (LUMC)Leidenthe Netherlands
- Duchenne Centerthe Netherlands
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Tang H, Yu L, Suo S, Hu Y, Wang J, Xu J, Lu Q, Zhou Y. Evaluation of skeletal muscle perfusion changes in patients with peripheral artery disease before and after percutaneous transluminal angioplasty using multiparametric MR imaging. Magn Reson Imaging 2022; 93:157-162. [DOI: 10.1016/j.mri.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/10/2022] [Accepted: 08/02/2022] [Indexed: 11/30/2022]
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Zaeske C, Brueggemann GP, Willwacher S, Maehlich D, Maintz D, Bratke G. The behaviour of T2* and T2 relaxation time in extrinsic foot muscles under continuous exercise: A prospective analysis during extended running. PLoS One 2022; 17:e0264066. [PMID: 35176114 PMCID: PMC8893273 DOI: 10.1371/journal.pone.0264066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 02/02/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives Previous studies on T2* and T2 relaxation time of the muscles have shown that exercise leads to an initial increase, presumably representing different intramuscular physiological processes such as increase in intracellular volume or blood oxygenation level dependent effects with a subsequent decrease after cessation of exercise. Their behaviour during prolonged exercise is still unknown but could provide important information for example about the pathophysiology of overuse injuries. The aim of this study was to evaluate the temporal course of T2* and T2 relaxation time in extrinsic foot muscles during prolonged exercise and determine the optimal mapping technique. Methods Ten participants had to run a total of 75 minutes at their individual highest possible running speed, with interleaved MR scans at baseline and after 2.5, 5, 10, 15, 45 and 75 minutes. The examined extrinsic foot muscles were manually segmented, and relaxation time were analysed regarding its respective time course. Results T2* and T2 relaxation time showed an initial increase, followed by a plateau phase between 2.5 and 15 minutes and a subsequent decrease. For the T2* relaxation time, this pattern was also apparent, but less pronounced, with more muscles not reaching significance (p<0.05) when comparing different time points. Conclusions T2* and T2 relaxation time showed a similar course with an initial rapid increase, a plateau phase and a subsequent decrease under prolonged exercise. Moderate but long-term muscular activity appears to have a weaker effect on T2* relaxation time than on T2 relaxation time.
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Affiliation(s)
- Charlotte Zaeske
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- * E-mail:
| | | | - Steffen Willwacher
- Institute of Biomechanics and Orthopaedics, German Sport University, Cologne, Germany
| | - Daniela Maehlich
- Institute of Biomechanics and Orthopaedics, German Sport University, Cologne, Germany
| | - David Maintz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Grischa Bratke
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Caroca S, Villagran D, Chabert S. Four functional magnetic resonance imaging techniques for skeletal muscle exploration, a systematic review. Eur J Radiol 2021; 144:109995. [PMID: 34628310 DOI: 10.1016/j.ejrad.2021.109995] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The study of muscle health has become more relevant lately, due to global aging and a higher incidence of musculoskeletal pathologies. Current exploration techniques, such as electromyography, do not provide accurate spatial information. OBJECTIVE The objective of this work is to perform a systematic review of the literature to synthesize the contributions that can offer functional MRI techniques commonly used in neuroimaging, applied to skeletal muscle: Blood Oxygen Level Dependent (BOLD), IntraVoxel Incoherent Motion (IVIM), Arterial Spin Labeling (ASL) and Dynamic Contrast Enhanced (DCE). EVIDENCE ACQUISITION Web of Science and Medline databases were searched, over the last 10 years, focused on the use of BOLD, ASL, IVIM or DCE in skeletal muscle. EVIDENCE SYNTHESIS 59 articles were included after applying the selection criteria. 37 studies were performed in healthy subjects, and 22 in patients with different pathologies: in peripheral arterial disease, systemic sclerosis, diabetes, osteoporosis, adolescent idiopathic scoliosis, and dermatomyositis. Reference values in healthy subjects still vary in some cases. CONCLUSION The studies show the feasibility of implementing functional MRI through BOLD, ASL, IVIM or DCE imaging in several muscles and their possible utility in different pathologies. A synthesis of how to implement such exploration is given here. CLINICAL IMPACT These four techniques are based on sequences already present in clinical MRI scanners, therefore, their use for functional muscle exploration does not require additional investment. These techniques allow visualization and quantification of parameters associated with the vascular health of the muscles and represent interesting support for musculoskeletal exploration.
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Affiliation(s)
- Sergio Caroca
- Biomedical Engineering Department, Universidad de Valparaiso, Valparaíso, Chile
| | - Diego Villagran
- Servicio de Imagenología, Hospital Carlos van Buren, Valparaíso, Chile
| | - Steren Chabert
- Biomedical Engineering Department, Universidad de Valparaiso, Valparaíso, Chile; CINGS, Centro de Investigación y Desarrollo en INGeniería en Salud, Universidad de Valparaiso, Valparaíso, Chile; Millennium Nucleus for Cardiovascular Magnetic Resonance, Chile.
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Englund EK, Reiter DA, Shahidi B, Sigmund EE. Intravoxel Incoherent Motion Magnetic Resonance Imaging in Skeletal Muscle: Review and Future Directions. J Magn Reson Imaging 2021; 55:988-1012. [PMID: 34390617 DOI: 10.1002/jmri.27875] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 12/29/2022] Open
Abstract
Throughout the body, muscle structure and function can be interrogated using a variety of noninvasive magnetic resonance imaging (MRI) methods. Recently, intravoxel incoherent motion (IVIM) MRI has gained momentum as a method to evaluate components of blood flow and tissue diffusion simultaneously. Much of the prior research has focused on highly vascularized organs, including the brain, kidney, and liver. Unique aspects of skeletal muscle, including the relatively low perfusion at rest and large dynamic range of perfusion between resting and maximal hyperemic states, may influence the acquisition, postprocessing, and interpretation of IVIM data. Here, we introduce several of those unique features of skeletal muscle; review existing studies of IVIM in skeletal muscle at rest, in response to exercise, and in disease states; and consider possible confounds that should be addressed for muscle-specific evaluations. Most studies used segmented nonlinear least squares fitting with a b-value threshold of 200 sec/mm2 to obtain IVIM parameters of perfusion fraction (f), pseudo-diffusion coefficient (D*), and diffusion coefficient (D). In healthy individuals, across all muscles, the average ± standard deviation of D was 1.46 ± 0.30 × 10-3 mm2 /sec, D* was 29.7 ± 38.1 × 10-3 mm2 /sec, and f was 11.1 ± 6.7%. Comparisons of reported IVIM parameters in muscles of the back, thigh, and leg of healthy individuals showed no significant difference between anatomic locations. Throughout the body, exercise elicited a positive change of all IVIM parameters. Future directions including advanced postprocessing models and potential sequence modifications are discussed. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Erin K Englund
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - David A Reiter
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia, USA.,Department of Orthopedics, Emory University, Atlanta, Georgia, USA
| | - Bahar Shahidi
- Department of Orthopaedic Surgery, UC San Diego, San Diego, California, USA
| | - Eric E Sigmund
- Department of Radiology, New York University Grossman School of Medicine, NYU Langone Health, New York, New York, USA.,Center for Advanced Imaging and Innovation (CAI2R), Bernard and Irene Schwarz Center for Biomedical Imaging (CBI), NYU Langone Health, New York, New York, USA
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