Evaluation of the Reproducibility of MR Elastography Measurements of the Lumbar Back Muscles.
MR elastography
low back pain
lumbar back muscles
reproducibility
stiffness
Journal
Journal of magnetic resonance imaging : JMRI
ISSN: 1522-2586
Titre abrégé: J Magn Reson Imaging
Pays: United States
ID NLM: 9105850
Informations de publication
Date de publication:
15 Dec 2023
15 Dec 2023
Historique:
revised:
21
11
2023
received:
13
09
2023
accepted:
22
11
2023
medline:
15
12
2023
pubmed:
15
12
2023
entrez:
15
12
2023
Statut:
aheadofprint
Résumé
MR elastography (MRE) may provide quantitative imaging biomarkers of lumbar back muscles (LBMs), complementing MRI in spinal diseases by assessing muscle mechanical properties. However, reproducibility analyses for MRE of LBM are lacking. To assess technical failure, within-day and inter-day reproducibility, robustness with the excitation source positioning, and inter-observer agreement of MRE of muscles. Prospective. Seventeen healthy subjects (mean age 28 ± 4 years; 11 females). 1.5 T, gradient-echo MRE, T1-weighted turbo spin echo. The pneumatic driver was centered at L3 level. Four MRE were performed during two visits, 2-4 weeks apart, each consisting of two MRE with less than 10 minutes inter-scan interval. At Visit 1, after the first MRE, the coil and driver were removed, then reinstalled. The MRE was repeated. At Visit 2, following the first MRE, only the driver was moved down 5 cm. The MRE was repeated. Two radiologists segmented the multifidus and erector spinae muscles. Paired t-test, analysis of variance, intraclass correlation coefficients (ICCs). P-values <0.05 were considered statistically significant. Mean stiffness of LBM ranged from 1.44 to 1.60 kPa. Mean technical failure rate was 2.5%. Inter-observer agreement was excellent (ICC ranging from 0.82 [0.64-0.96] to 0.99 [0.98-0.99] in the multifidus, and from 0.85 [0.69-0.92] to 0.99 [0.97-0.99] in the erector spinae muscles). Within-day reproducibility was fair in the multifidus (ICC: 0.53 [0.47-0.77]) and good in the erector spinae muscles (ICC: 0.74 [0.48-0.88]). Reproducibility after moving the driver was excellent in both multifidus (ICC: 0.85 [0.69-0.93]) and erector spinae muscles (ICC: 0.84 [0.67-0.92]). Inter-day reproducibility was excellent in the multifidus (ICC: 0.76 [0.48-0.89]) and poor in the erector spinae muscles (ICC: 0.23 [-0.61 to 0.63]). MRE of LBM provides measurements of stiffness with fair to excellent reproducibility and excellent inter-observer agreement. However, inter-day reproducibility in the multifidus muscles indicated that the herein used MRE protocol may not be optimal for this muscle. 2 TECHNICAL EFFICACY: Stage 1.
Sections du résumé
BACKGROUND
BACKGROUND
MR elastography (MRE) may provide quantitative imaging biomarkers of lumbar back muscles (LBMs), complementing MRI in spinal diseases by assessing muscle mechanical properties. However, reproducibility analyses for MRE of LBM are lacking.
PURPOSE
OBJECTIVE
To assess technical failure, within-day and inter-day reproducibility, robustness with the excitation source positioning, and inter-observer agreement of MRE of muscles.
STUDY TYPE
METHODS
Prospective.
SUBJECTS
METHODS
Seventeen healthy subjects (mean age 28 ± 4 years; 11 females).
FIELD STRENGTH/SEQUENCE
UNASSIGNED
1.5 T, gradient-echo MRE, T1-weighted turbo spin echo.
ASSESSMENT
RESULTS
The pneumatic driver was centered at L3 level. Four MRE were performed during two visits, 2-4 weeks apart, each consisting of two MRE with less than 10 minutes inter-scan interval. At Visit 1, after the first MRE, the coil and driver were removed, then reinstalled. The MRE was repeated. At Visit 2, following the first MRE, only the driver was moved down 5 cm. The MRE was repeated. Two radiologists segmented the multifidus and erector spinae muscles.
STATISTICAL TESTS
METHODS
Paired t-test, analysis of variance, intraclass correlation coefficients (ICCs). P-values <0.05 were considered statistically significant.
RESULTS
RESULTS
Mean stiffness of LBM ranged from 1.44 to 1.60 kPa. Mean technical failure rate was 2.5%. Inter-observer agreement was excellent (ICC ranging from 0.82 [0.64-0.96] to 0.99 [0.98-0.99] in the multifidus, and from 0.85 [0.69-0.92] to 0.99 [0.97-0.99] in the erector spinae muscles). Within-day reproducibility was fair in the multifidus (ICC: 0.53 [0.47-0.77]) and good in the erector spinae muscles (ICC: 0.74 [0.48-0.88]). Reproducibility after moving the driver was excellent in both multifidus (ICC: 0.85 [0.69-0.93]) and erector spinae muscles (ICC: 0.84 [0.67-0.92]). Inter-day reproducibility was excellent in the multifidus (ICC: 0.76 [0.48-0.89]) and poor in the erector spinae muscles (ICC: 0.23 [-0.61 to 0.63]).
DATA CONCLUSION
CONCLUSIONS
MRE of LBM provides measurements of stiffness with fair to excellent reproducibility and excellent inter-observer agreement. However, inter-day reproducibility in the multifidus muscles indicated that the herein used MRE protocol may not be optimal for this muscle.
EVIDENCE LEVEL
METHODS
2 TECHNICAL EFFICACY: Stage 1.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.
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