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• Technical Article •
Application value of T2WI-Dixon water fat separation sequence in the evaluation of muscle fat infiltration and edema in patient with Duchenne muscular dystrophy
SHI Cailing  FU Hang  GUO Yingkun  CAI Xiaotang  XU Huayan  YUE Wenjun 

Cite this article as: Shi CL, Fu H, Guo YK, et al. Application value of T2WI-Dixon water fat separation sequence in the evaluation of muscle fat infiltration and edema in patient with Duchenne muscular dystrophy[J]. Chin J Magn Reson Imaging, 2022, 13(7): 96-102. DOI:10.12015/issn.1674-8034.2022.07.017.


[Abstract] Objective This study aimed to compare image quality of T2-weighted imaging water-fat separation (T2WI-Dixon) sequence with conventional sequence [T1WI and T2WI-SPAIR (spectral attenuated inversion recovery) sequence] and the consistency in evaluating the degree of fatty infiltration and edema in the gluteal and leg muscles of patient with Duchenne muscular dystrophy (DMD), and to investigate the value of T2WI-Dixon as a single sequence in assessing the gluteal and leg muscles of patient with DMD.Materials and Methods A total of 71 patient with DMD were prospectively enrolled for 3.0 T magnetic resonance imaging scanning of the hip and thigh. The scanning sequences included T2WI-Dixon fast spin echo sequence, T1WI sequence and T2WI-SPAIR sequence. The image quality of each sequence was comprehensively evaluated by combining subjective (Likert 4-point scale, including image artifacts, fat suppression ability, and overall quality) with objective [quantitative measurement of image SNR (signal-noise ratio) and CNR (contrast-to-noise ratio)] methods. The degree of muscle fatty infiltration and edema were scored using the Mercuri grading scale and the Kim grading scale to assess consistency between methods. Inter-observer and intra-observer subjective score consistency were also assessed.Results In terms of subjective evaluation of image quality, the artifact and overall image quality score of T2WI-Dixon-fat were higher than those of T1WI (P＜0.001). The fat suppression uniformity, artifact and overall image quality scores of T2WI-Dixon-water images were also higher than those of T2WI-SPAIR images (P＜0.001). In objective evaluation, CNR of T2WI-Dixon-fat images were significantly higher than that of T1WI, while SNR were significantly lower than that of T1WI (P＜0.001). SNR and CNR of T2WI-Dixon-water images were higher than those of T2WI-SPAIR (P＜0.001). T2WI-Dixon-fat showed excellent consistency with T1WI in evaluating the degree of muscle fat infiltration (Kappa=0.95, P＜0.001). T2WI-Dixon-water and T2WI-SPAIR also had excellent consistency in evaluating the degree of muscle edema (Kappa=0.84, P＜0.001). The intra-observer and inter-observer subjective scores were moderate-excellent consistent, with Kappa values of 0.42-0.86, all P＜0.001.Conclusions T2WI-Dixon sequence has good consistency with conventional sequence in the evaluation of muscle fat infiltration and edema, and can significantly shorten the scanning time and improve image quality, which has good application value in the evaluation of gluteal and leg muscle injury in patient with DMD.
[Keywords] magnetic resonance imaging；water fat separation imaging；Duchenne muscular dystrophy；fat infiltration；edema；image quality

SHI Cailing1   FU Hang2   GUO Yingkun2   CAI Xiaotang3   XU Huayan2   YUE Wenjun1*  

1 Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China

2 Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, Department of Radiology, West China Second Hospital, Sichuan University, Chengdu 610041, China

3 Key Laboratory of Urban Defects and Related Women and Children's Diseases of Ministry of Education, Department of Pediatric Neurology, West China Second Hospital, Sichuan University, Chengdu 610041, China

Yue WJ, E-mail: ywj820@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS National Natural Science Foundation of China (No. 81901712).
Received  2022-03-01
Accepted  2022-06-24
DOI: 10.12015/issn.1674-8034.2022.07.017
Cite this article as: Shi CL, Fu H, Guo YK, et al. Application value of T2WI-Dixon water fat separation sequence in the evaluation of muscle fat infiltration and edema in patient with Duchenne muscular dystrophy[J]. Chin J Magn Reson Imaging, 2022, 13(7): 96-102. DOI:10.12015/issn.1674-8034.2022.07.017.

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