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T2-Weighted Dixon Turbo Spin Echo for Accelerated Simultaneous Grading of Whole-Body Skeletal Muscle Fat Infiltration and Edema in Patients With Neuromuscular Diseases

Schlaeger, Sarah*†; Klupp, Elisabeth, MD*; Weidlich, Dominik, MSc; Cervantes, Barbara, MSc; Foreman, Sarah C.*; Deschauer, Marcus, MD; Schoser, Benedikt, MD§; Katemann, Christoph; Kooijman, Hendrik, PhD; Rummeny, Ernst J., MD; Zimmer, Claus, MD*; Kirschke, Jan S., PD*; Karampinos, Dimitrios C., PD

Journal of Computer Assisted Tomography: July/August 2018 - Volume 42 - Issue 4 - p 574–579
doi: 10.1097/RCT.0000000000000723
Musculoskeletal Imaging

Objective The assessment of fatty infiltration and edema in the musculature of patients with neuromuscular diseases (NMDs) typically requires the separate performance of T1-weighted and fat-suppressed T2-weighted sequences. T2-weighted Dixon turbo spin echo (TSE) enables the generation of T2-weighted fat- and water-separated images, which can be used to assess both pathologies simultaneously. The present study examines the diagnostic performance of T2-weighted Dixon TSE compared with the standard sequences in 10 patients with NMDs and 10 healthy subjects.

Methods Whole-body magnetic resonance imaging was performed including T1-weighted Dixon fast field echo, T2-weighted short-tau inversion recovery, and T2-weighted Dixon TSE. Fatty infiltration and intramuscular edema were rated by 2 radiologists using visual semiquantitative rating scales. To assess intermethod and interrater agreement, weighted Cohen's κ coefficients were calculated.

Results The ratings of fatty infiltration showed high intermethod and high interrater agreement (T1-weighted Dixon fast field echo vs T2-weighted Dixon TSE fat image). The evaluation of edematous changes showed high intermethod and good interrater agreement (T2-weighted short-tau inversion recovery vs T2-weighted Dixon TSE water image).

Conclusions T2-weighted Dixon TSE imaging is an alternative for accelerated simultaneous grading of whole-body skeletal muscle fat infiltration and edema in patients with NMDs.

From the Departments of *Diagnostic and Interventional Neuroradiology,

Diagnostic and Interventional Radiology, and

Neurology, Technical University of Munich;

§Friedrich-Baur-Institut, Ludwig Maximilian University, Munich; and

Philips Healthcare, Hamburg, Germany.

Received for publication October 2, 2017; accepted December 26, 2017.

Correspondence to: Sarah Schlaeger, Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Ismaninger Str 22, 81675 Munich, Germany (e-mail:

S.S and E.K. contributed equally to this work.

The authors declare no conflict of interest.

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