Effect of ankle flexion on the quantification of MRS for intramyocellular lipids of the tibialis anterior and the medial gastrocnemius

Effects of muscle fiber orientation to main magnetic field on muscle metabolite profiles for magnetic resonance spectroscopy acquisition

BACKGROUND

Proton magnetic resonance spectroscopy (¹H MRS) is a technique widely used for investigating metabolites in humans. Lipids are stored outside the muscle cell are called extramyocellular lipids (EMCL), and lipids stored on the inside of muscle cells are called intramyocellular lipids (IMCL). The relationship between metabolic syndrome and IMCL has been extensively studied.

AIM

To determine the effects of muscle fiber orientations on muscle metabolites using ¹H MRS.

METHODS

Chicken muscles were used as the subject in this study. MRS spectra were performed on a 1.5T Magnetic resonance imaging machine (1.5 Tesla Philips Achieva). A single voxel (8 mm × 8 mm × 20 mm) was placed on the chicken extensor iliotibialis lateralis muscle with the muscle fiber oriented at 0°, 30°, 60°, and 90° to the main magnetic field. ¹H MRS spectra were acquired using a point-resolved spectroscopy, TR = 2000 ms, TE = 30 ms, and NSA = 256. Metabolites of interest from each orientation to the main magnetic field were compared using Wilcoxon signed-rank test. Differences less than 0.05 were considered to be statistically significant with 95%CI.

RESULTS

The metabolite profiles were different for each orientation of muscle fibers to the main magnetic field. The orientation at 90° was the most different compared to other orientations. The quantity of IMCL and EMCL exhibited statistically significantly changes with impacts at 30°, 60°, and 90° when compared with muscles aligned at 0° to the main magnetic field. Statistical analysis showed statistically significant IMCL (CH₃), EMCL (CH₃), and IMCL (CH₂) at 30°, 60°, and 90° (P = 0.017, 0.018, and 0.018, respectively) and EMCL (CH₂) at 30° and 60° (P = 0.017 and 0.042, respectively). EMCL (CH₂) at 90° was unable to be measured in this study. The muscle lipids quantified at 30°, 60°, and 90° tended to be lower when compared to 0°.

CONCLUSION

Careful positioning is one of the most important factors to consider when studying ¹H MRS metabolites in muscles to ensure reproducibility and uniformity of muscle metabolite spectra.

Analysis of intra and extramyocellular lipids in the multifidus muscle in patients with chronic low back pain using MR spectroscopy

OBJECTIVE

To analyse the intra- (IMCL) and extramyocellular lipids (EMCL) concentration in the multifidus muscle (Mm) using MR spectroscopy (MRS) in patients with low back pain (LBP), and to evaluate the correlation between those lipid concentrations and age, obesity, atrophy of the Mm and LBP intensity.

METHODS

60 LBP patients underwent routine diagnostic MRI of the lumbar spine before undergoing imaging for the study. Body mass index, as an indicator of obesity and visual analogue scale, as an indicator of LBP were also measured. Proton MRS was acquired with a single-voxel point-resolved spectroscopy sequence. Furthermore, the MRS volume of interest for measuring the IMCL and EMCL concentration at L4/5 for the right Mm was determined, and we measured the cross-sectional area of Mm as an indicator of muscle atrophy.

RESULTS

Age showed correlation with EMCL concentration (r = 0.314, p = 0.008). The body mass index showed correlation with EMCL concentration (r = 0.358, p = 0.005). The cross-sectional area of Mm showed correlation with EMCL concentration (r = -0.543, p < 0.001). Moreover, the LBP visual analogue scale showed correlation with IMCL concentration (r = 0.367, p = 0.004).

CONCLUSION

There were correlations between age, obesity, muscle atrophy, and EMCL concentration in Mm. IMCL concentration in Mm showed a correlation with LBP intensity. This may suggest that IMCL concentration could become an effective objective indicator of chronic LBP intensity. Advances in knowledge: We investigated the characteristics of fat content in Mm with LBP patients. This study was demonstrated the association of the IMCL and EMCL concentration in Mm with various patient parameters.

The influence of leg positioning on the appearance and quantification of 1H magnetic resonance muscle spectra obtained from calf muscle

PURPOSE

To study proton magnetic resonance spectra (¹H-MRS) of the muscle metabolite of a leg muscle in neutral (NEU), internal rotation (INT), and external rotation (EXT) leg positioning.

MATERIAL AND METHODS

The volunteers were selected for this study. The tibialis anterior (TA), soleus (SOL), and gastrocnemius (GAS) muscles of a non-dominate leg were determined by using single-voxel spectroscopy 8 × 8 × 20 mm³ in size. ¹H-MRS measurements were performed on a 1.5-Tesla magnetic resonance imaging (MRI) scanner.

RESULTS

The results showed that metabolite spectrum of muscle in each NEU, INT, and EXT of leg positioning were not similar. Additionally, the quantification of IMCL (CH₃) and EMCL (CH₃) is significantly different in SOL.

CONCLUSIONS

Our study showed that leg positioning influences the appearance and quantification of ¹H-MRS in the calf muscle. Hence, it is necessary to pay close attention to positioning because it interferes with spectral fitting and quantification.

Evaluation of intramyocellular and extramyocellular lipids in the paraspinal muscle in patients with chronic low back pain using MR spectroscopy: preliminary results

OBJECTIVE:

To analyze the intramyocellular lipids (IMCL) and extramyocellular lipids (EMCL) in the psoas muscle (Pm) and multifidus muscle (Mm) using MR spectroscopy (MRS) in patients with chronic low back pain (CLBP) and asymptomatic volunteers.

METHODS:

This prospective study had institutional review board approval, and written informed consent was obtained from all individual participants. 20 patients with CLBP (mean age, 49.8 ± 12.5 years; age range, 28-66 years) with low back pain (LBP) duration of ≥3 months and asymptomatic volunteers (mean age, 44.0 ± 12.8 years; age range, 28-65 years) underwent MRS for the quantification of IMCL and EMCL of the right Pm and Mm in a volume of interest at the intervertebral level of L4 through L5. We compared patients with CLBP and asymptomatic volunteers for age and body mass index (BMI), IMCL and EMCL of Pm and Mm. The Mann-Whitney U-test was used for significant difference testing, with p-value <0.05 indicating statistical significance.

RESULTS:

No statistically significant differences were observed in the age and BMI of patients with CLBP and asymptomatic volunteers. There was no statistically significant difference in the EMCL and IMCL in Pm between the two groups. EMCL in Mm was not statistically significantly different; the IMCL of patients with CLBP was significantly higher than that of asymptomatic volunteers (p < 0.05).

CONCLUSION:

MRS demonstrates that IMCL in the Mm of patients with CLBP is significantly higher than that of asymptomatic volunteers. The increase of IMCL in the Mm may be a characteristic finding in CLBP.

ADVANCES IN KNOWLEDGE:

We investigated the detail of the fat content in the paraspinal muscles in patients CLBP and asymptomatic volunteers. The increase of fat content in the Mm of patients with LBP on previous studies was demonstrated to be the increase of IMCL.