Preliminary analysis of interaction of the fat fraction in the sacroiliac joint among sex, age, and body mass index in a normal Chinese population

The quantitative parameters derived from IDEAL-IQ in the lumbar vertebrae of healthy children: a pilot study of bone development

Background

Early childhood bone development affects that of bone disease in adolescence and adulthood. Many diseases can affect the cancellous bone or bone marrow. Therefore, it is of great significance to quantify the bone development of healthy children. The evaluation methods of bone development include bone age (BA) assessment and dual-energy X-ray bone mineral densitometry (DXA), both of which have strong subjectivity. The present study was conducted to improve our understanding of the bone development of healthy children using the quantitative parameters derived from iterative decomposition of water and fat with echo asymmetry and least squares estimation quantification (IDEAL-IQ) sequence.

Methods

Our study enrolled healthy children between January 2022 to December 2022 consecutively in Children's Hospital of Shanxi. The inclusion criteria were as follows: (I) age ≤18 years; (II) no contraindications (surgical and interventional devices for ferromagnetic materials, cardiac implantable electronic devices, cochlear implants, insulin pumps, dental implants containing metal or alloy) to magnetic resonance imaging (MRI) scan. The exclusion criteria were as follows: (I) previous malignant disease, (II) previous chemoradiotherapy, (III) previous spine surgery, (IV) previous or acute vertebral compression fracture, (V) artifacts present in images. Participants underwent MRI scans using IDEAL-IQ sequence in the lumbar vertebrae. The IDEAL-IQ parameters [proton density fat fraction (PDFF), 1/T2* (R2*)] were obtained. The factor analysis of variance was applied to compare the differences of PDFF and R2* in different lumbar vertebral groups. The Kruskal-Wallis H test or Mann-Whitney U test was applied to compare the differences of quantitative data among different gender or age groups. Spearman correlation analysis was applied to study the relationship among the age, PDFF, and R2*.

Results

A total of 145 participants (76 males, 69 females) were evaluated. There were no significant differences in PDFF and R2* of different lumbar vertebrae (PPDFF=0.338, PR2*=0.868). The average age was 36 [13-72] months. They were assigned into 4 groups (0-11, 12-35, 36-71, and 72-144 months). As the age increased, the average PDFF and R2* both increased significantly (rPDFF=0.659, rR2*=0.359, P<0.001). There were significant statistical differences in PDFF and R2* between the 4 age groups (ZPDFF=46.651, ZR2*=27.537, P<0.001). Moreover, the PDFF was also positively correlated with R2* (r=0.576, P<0.001). No association was found between the gender and PDFF, R2* (PPDFF=0.949, PR2*=0.177).

Conclusions

The quantitative parameters derived from IDEAL-IQ in the lumbar vertebrae of healthy children will improve our understanding of bone development and provide a basis for further exploring the diseases that affect children's bone development.

Fatty Acids Composition of the Sacroiliac Joint in Axial Spondyloarthritis: Analysis Using 3.0 T Chemical Shift-Encoded MRI

BACKGROUND

Axial spondyloarthritis (axSpA) is a group of inflammatory diseases that may lead to ankylosis of the sacroiliac joint and spine. Fat lesion in the sacroiliac joint is an important feature in diagnosis and disease progression of axSpA. However, whether there is alteration of fatty acids (FAs) composition has not been investigated using MRI.

PURPOSE

To investigate bone marrow FA composition of the sacroiliac joint in patients with axSpA compared to controls.

STUDY TYPE

Prospective.

SUBJECTS

Eighty five participants (mean age, 32.3 ± 6.1 years): 48 axSpA (25 male, 23 female) and 37 non-SpA controls (18 male, 19 female).

FIELD STRENGTH/SEQUENCE

3.0 T/Two multiple gradient-echo chemical shift-encoded (CSE) MRI which differed only in echo times (TEs) were scanned consecutively.

ASSESSMENT

Axial multi-echo CSE MRI was performed in the sacroiliac joints in vivo. Regions of interest (ROIs) were manually placed on subchondral bone with and without fat lesion in axSpA patients, and on subchondral bone without fat lesion in controls. FA composition was computed within the ROIs using a nonlinear least square method from literature.

STATISTICAL TESTS

Intergroup comparisons were performed using t tests.

RESULTS

In axSpA, male patients had significantly higher monounsaturated FA compared to controls in areas with fat lesion in the sacrum (+12%) and in the ilium (+9%), and in areas without fat lesion in the sacrum (+10%). Significantly lower polyunsaturated FAs were found in areas with fat lesion in the sacrum (-10%) and ilium (-11%), and lower saturated FAs were found in areas without fat lesion in the sacrum (-6%). In female, patients with axSpA had significantly higher saturated FAs in areas with fat lesion in the ilium (+7%) in comparison to controls.

DATA CONCLUSION

FA composition of the sacroiliac joint alters in patients with axSpA, and it can be detected using CSE MRI based analysis.

Chemical Shift-Encoded MRI of Bone Metabolic Markers in Ankylosing Spondylitis

Objective

To investigate the feasibility and correlation of sacroiliac joint (SIJ) fat fraction (FF) and R2^∗ as markers of bone metabolism in patients with ankylosing spondylitis (AS).

Methods

75 AS patients were classified into an early active group (EA), late active group (LA), and inactive group (IA). Additionally, 54 matched healthy individuals were selected to be part of the normal control group (NC). All participants underwent chemical shift encoded based MRI (IDEAL-IQ) and routine clinical SIJ MRI at 3.0 T. FF and R2^∗ were measured in subchondral bone, bone marrow edema (BME), and fat metaplasia (FM). Out of the participants, 39 with BME lesions (15 from EA, 16 from LA, 8 from IA) and 39 with FM lesions (9 from EA, 17 from LA, 13 from IA) were included. Differences in FF, R2^∗ value for subchondral bone of all participants and for BME, FM lesions were evaluated. Subsequently, different stages of BME and FM in patient groups were compared, and the relationship between FF and R2^∗ was analyzed.

Results

A significant difference in FF was demonstrated among the BME, FM and the normal bone marrow (p < 0.001), meanwhile, the difference of R2^∗ value in FM was significantly lower (p = 0.034, 0.012) than that of BME and that of normal bone marrow. At lever of different lesions, only the FF for BME was significantly different among 3 patient groups (p = 0.001), while there was no significantly different FF for FM among 3 patient groups. Unlike in BME lesions, the FF in FM lesions had a negative correlation with R2^∗ (p < 0.001, r = −0.488).

Conclusion

FF and R2^∗ measurements help to quantitatively analyze the bone marrow fat composition and bony trabecular microstructure changes in AS, providing a noninvasive and accurate assessment basis for AS bone metabolism abnormalities.

Assessment of bone marrow fat fractions in the mandibular condyle head using the iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL-IQ) method

The prevalence of temporomandibular joint disorder (TMD) is gradually increasing, and magnetic resonance imaging (MRI) is becoming increasingly common as a modality used to diagnose TMD. Edema and osteonecrosis in the bone marrow of the mandibular condyle have been considered to be precursors of osteoarthritis, but these changes are not evaluated accurately and quantitatively on routine MRI. The iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL-IQ) method, as a cutting-edge MRI technique, can separate fat and water using three asymmetric echo times and the three-point Dixon method. The purpose of this study was to analyze the quantitative fat fraction (FF) in the mandibular condyle head using the IDEAL-IQ method. Seventy-nine people who underwent MRI using IDEAL-IQ were investigated and divided into 1) the control group, without TMD symptoms, and 2) the TMD group, with unilateral temporomandibular joint (TMJ) pain. In both groups, the FF of the condyle head in the TMJ was analyzed by two oral and maxillofacial radiologists. In the TMD group, 29 people underwent cone-beam computed tomography (CBCT) and the presence or absence of bony changes in the condylar head was evaluated. The FF measurements of the condyle head using IDEAL-IQ showed excellent inter-observer and intra-observer agreement. The average FF of the TMD group was significantly lower than that of the control group (p < 0.05). In the TMD group, the average FF values of joints with pain and joints with bony changes were significantly lower than those of joints without pain or bony changes, respectively (p < 0.05). The FF using IDEAL-IQ in the TMJ can be helpful for the quantitative diagnosis of TMD.