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Updated: Jun 4, 2026
Quantitative Magnetic Resonance Imaging of Skeletal Muscle Disease
Published on: December 18, 2016
Muscle fat fraction in neuromuscular disorders: dual-echo dual-flip-angle spoiled gradient-recalled MR imaging
Michele Gaeta1, Emanuele Scribano, Achille Mileto
1Department of Radiological Sciences, Policlinico G. Martino, Via Consolare Valeria 1, 98125 Messina, Italy.
Purpose:
To prospectively evaluate the muscle fat fraction (MFF) measured with dual-echo dual-flip-angle spoiled gradient-recalled acquisition in the steady state (SPGR) magnetic resonance (MR) imaging technique by using muscle biopsy as the reference standard.
Materials And Methods:
After ethics approval, written informed consent from all patients was obtained. Twenty-seven consecutive patients, evaluated at the Neuromuscular Disorders Center with a possible diagnosis of neuromuscular disorder, were prospectively studied with MR imaging of the lower extremities to quantify muscle fatty infiltration by means of MFF calculation. Spin-density- and T1-weighted fast SPGR in-phase and opposed-phase dual-echo sequences were performed, respectively, with 20° and 80° flip angles. Round regions of interest were drawn by consensus on selected MR sections corresponding to anticipated biopsy sites. These were marked on the patient's skin with a pen by using the infrared spider light of the system, and subsequent muscle biopsy was performed. MR images with regions of interest were stored on a secondary console where the MFF calculation was performed by another radiologist blinded to the biopsy results. MFFs calculated with dual-echo dual-flip-angle SPGR MR imaging and biopsy were compared by using a paired t test, Pearson correlation coefficient, and Bland-Altman plots. P value of < .05 was considered to indicate a statistically significant difference.
Results:
The mean MFFs obtained with dual-echo dual-flip-angle SPGR MR imaging and biopsy were 20.3% (range, 1.7%-45.1%) and 20.6% (range, 3%-46.1%), respectively. The mean difference, standard deviation of the difference, and t value were -0.3, 1.3, and -1.3 (P > .2), respectively. The Pearson correlation coefficient was 0.995; with the Bland-Altman method, all data points were within the ± 2 SDs limits of agreement.
Conclusion:
The results show that dual-echo dual-flip-angle SPGR MR imaging technique provides reliable calculation of MFF, consistent with biopsy measurements.
