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Author Spotlight: Decellularization-Based Quantification of Skeletal Muscle Fatty Infiltration
Published on: June 9, 2023
Heterogeneity of muscle fat infiltration in children with spina bifida
Tishya A L Wren1, Skorn Ponrartana, Alexander Van Speybroeck
1Children's Orthopaedic Center and Department of Radiology, Children's Hospital Los Angeles, United States.
Insights
Children with spina bifida show significant muscle fat infiltration, impacting strength. Quantitative water-fat MRI reveals detailed muscle changes, aiding in predicting functional potential.
Area of Science:
- Biomedical Engineering
- Neurology
- Pediatrics
Background:
- Children with spina bifida experience muscle functional deficits.
- Muscle anatomy and composition changes in spina bifida are not well understood.
Purpose of the Study:
- To investigate muscle fat infiltration in children with myelomeningocele using water-fat MRI.
- To correlate muscle fat fraction (FF) with manual muscle test (MMT) scores.
Main Methods:
- Water-fat magnetic resonance imaging (MRI) was used to measure FF in lower extremity muscles of 11 children with myelomeningocele.
- MRI measurements were compared with MMT scores for muscle strength.
- Inter-rater reliability and intraclass correlation coefficients were assessed for FF measurements.
Main Results:
- A significant inverse relationship was found between muscle FF and MMT scores (P ≤ 0.001).
- Muscles with negligible strength (MMT 0-1) showed a bimodal FF distribution (FF>70% or FF<20%).
- MRI revealed significant heterogeneity in FF within muscle groups and asymmetry in FF in one participant.
Conclusions:
- Quantitative water-fat MRI is a reliable method for assessing muscle fat infiltration in children with spina bifida.
- MRI findings suggest potential for water-fat MRI as a biomarker for muscle degeneration.
- This technique may help predict functional potential and prognosis in pediatric spina bifida patients.
Abstract:
Children with spina bifida have well recognized functional deficits of muscle, but little is known about the associated changes in muscle anatomy and composition. This study used water-fat magnetic resonance imaging (MRI) to measure fat infiltration in the lower extremity muscles of 11 children with myelomeningocele, the most severe form of spina bifida. MRI measurements of muscle fat fraction (FF) were compared against manual muscle test (MMT) scores for muscle strength. The FF measurements were objective and reliable with mean inter-rater differences of <2% and intraclass correlation coefficients>0.98. There was a significant inverse relationship between muscle FF and MMT scores (P ≤ 0.001). Surprisingly, however, muscles with negligible strength (MMT 0-1) exhibited a bimodal distribution of FF with one group having FF>70% and another group having FF<20%. The MRI also revealed striking heterogeneity amongst individual muscles in the same muscle group (e.g., 4% fat in one participant's lateral gastrocnemius vs. 88% in her medial gastrocnemius), as well as significant asymmetry in FF in one participant with asymmetric strength and sensation. These results suggest that quantitative water-fat MRI may serve as a biomarker for muscle degeneration which may reveal subclinical changes useful for predicting functional potential and prognosis.
