1H magnetic resonance spectroscopy findings in idiopathic inflammatory myopathies at 3 T: Feasibility and first results

Ty Subhawong, Xin Wang, Antonio J. MacHado, Andrew L. Mammen, Lisa Christopher-Stine, Peter B. Barker, John A. Carrino, Laura M. Fayad

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: The aim of this study was to investigate the feasibility and potential use of quantitative proton magnetic resonance spectroscopy (MRS) for determining metabolite concentrations in patients with suspected inflammatory myopathies. Materials and Methods: In this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant prospective study, 35 patients with a suspected inflammatory myopathy and 6 age-matched healthy volunteers underwent magnetic resonance imaging (MRI) (T1-weighted and short tau inversion recovery [STIR] sequences) and single-voxel MRS (point-resolved spectroscopy; repetition time/echo time, 2000/135 milliseconds; voxel size, 2.0 × 2.0 × 4.0 cm) at 3 T. The voxel was placed in a thigh muscle and targeted to one with abnormal STIR signal when possible. Absolute trimethylamine, creatine (Cr), and bulk lipid concentrations in each voxel were determined using the phantom replacement method. The MRS results of patients and healthy subjects were compared using the Wilcoxon rank sum test. Results: Twenty-one patients were diagnosed with an active idiopathic inflammatory myopathy (IIM). In 20 of these patients, MRI showed increased intramuscular STIR signal; however, the muscle where the voxel was placed was normal in 9 patients. Patients with an IIM demonstrated higher mean intramuscular Cr concentration compared with controls (62.1 vs 35.3 IU; P = 0.01), but there were no differences in the mean trimethylamine or lipid concentrations. In IIM patients with no intravoxel signal abnormality (9/21), the mean Cr concentration was still higher than that in healthy subjects (63.2 vs 35.3 IU; P = 0.001). Conclusions: Quantitative 3-T MRS is feasible and may supplement the role of conventional MRI in the evaluation of patients with inflammatory myopathies, especially where MRI shows no obvious muscle abnormalities.

Original languageEnglish
Pages (from-to)509-516
Number of pages8
JournalInvestigative Radiology
Volume48
Issue number7
DOIs
StatePublished - Jul 1 2013

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Myositis
Magnetic Resonance Spectroscopy
Creatine
Magnetic Resonance Imaging
Healthy Volunteers
Nonparametric Statistics
Muscles
Sequence Inversion
Health Insurance Portability and Accountability Act
Lipids
Research Ethics Committees
Thigh
Spectrum Analysis
Prospective Studies

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

1H magnetic resonance spectroscopy findings in idiopathic inflammatory myopathies at 3 T : Feasibility and first results. / Subhawong, Ty; Wang, Xin; MacHado, Antonio J.; Mammen, Andrew L.; Christopher-Stine, Lisa; Barker, Peter B.; Carrino, John A.; Fayad, Laura M.

In: Investigative Radiology, Vol. 48, No. 7, 01.07.2013, p. 509-516.

Research output: Contribution to journalArticle

Subhawong, T, Wang, X, MacHado, AJ, Mammen, AL, Christopher-Stine, L, Barker, PB, Carrino, JA & Fayad, LM 2013, '1H magnetic resonance spectroscopy findings in idiopathic inflammatory myopathies at 3 T: Feasibility and first results', Investigative Radiology, vol. 48, no. 7, pp. 509-516. https://doi.org/10.1097/RLI.0b013e3182823562
Subhawong, Ty ; Wang, Xin ; MacHado, Antonio J. ; Mammen, Andrew L. ; Christopher-Stine, Lisa ; Barker, Peter B. ; Carrino, John A. ; Fayad, Laura M. / 1H magnetic resonance spectroscopy findings in idiopathic inflammatory myopathies at 3 T : Feasibility and first results. In: Investigative Radiology. 2013 ; Vol. 48, No. 7. pp. 509-516.
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abstract = "OBJECTIVE: The aim of this study was to investigate the feasibility and potential use of quantitative proton magnetic resonance spectroscopy (MRS) for determining metabolite concentrations in patients with suspected inflammatory myopathies. Materials and Methods: In this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant prospective study, 35 patients with a suspected inflammatory myopathy and 6 age-matched healthy volunteers underwent magnetic resonance imaging (MRI) (T1-weighted and short tau inversion recovery [STIR] sequences) and single-voxel MRS (point-resolved spectroscopy; repetition time/echo time, 2000/135 milliseconds; voxel size, 2.0 × 2.0 × 4.0 cm) at 3 T. The voxel was placed in a thigh muscle and targeted to one with abnormal STIR signal when possible. Absolute trimethylamine, creatine (Cr), and bulk lipid concentrations in each voxel were determined using the phantom replacement method. The MRS results of patients and healthy subjects were compared using the Wilcoxon rank sum test. Results: Twenty-one patients were diagnosed with an active idiopathic inflammatory myopathy (IIM). In 20 of these patients, MRI showed increased intramuscular STIR signal; however, the muscle where the voxel was placed was normal in 9 patients. Patients with an IIM demonstrated higher mean intramuscular Cr concentration compared with controls (62.1 vs 35.3 IU; P = 0.01), but there were no differences in the mean trimethylamine or lipid concentrations. In IIM patients with no intravoxel signal abnormality (9/21), the mean Cr concentration was still higher than that in healthy subjects (63.2 vs 35.3 IU; P = 0.001). Conclusions: Quantitative 3-T MRS is feasible and may supplement the role of conventional MRI in the evaluation of patients with inflammatory myopathies, especially where MRI shows no obvious muscle abnormalities.",
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T2 - Feasibility and first results

AU - Subhawong, Ty

AU - Wang, Xin

AU - MacHado, Antonio J.

AU - Mammen, Andrew L.

AU - Christopher-Stine, Lisa

AU - Barker, Peter B.

AU - Carrino, John A.

AU - Fayad, Laura M.

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N2 - OBJECTIVE: The aim of this study was to investigate the feasibility and potential use of quantitative proton magnetic resonance spectroscopy (MRS) for determining metabolite concentrations in patients with suspected inflammatory myopathies. Materials and Methods: In this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant prospective study, 35 patients with a suspected inflammatory myopathy and 6 age-matched healthy volunteers underwent magnetic resonance imaging (MRI) (T1-weighted and short tau inversion recovery [STIR] sequences) and single-voxel MRS (point-resolved spectroscopy; repetition time/echo time, 2000/135 milliseconds; voxel size, 2.0 × 2.0 × 4.0 cm) at 3 T. The voxel was placed in a thigh muscle and targeted to one with abnormal STIR signal when possible. Absolute trimethylamine, creatine (Cr), and bulk lipid concentrations in each voxel were determined using the phantom replacement method. The MRS results of patients and healthy subjects were compared using the Wilcoxon rank sum test. Results: Twenty-one patients were diagnosed with an active idiopathic inflammatory myopathy (IIM). In 20 of these patients, MRI showed increased intramuscular STIR signal; however, the muscle where the voxel was placed was normal in 9 patients. Patients with an IIM demonstrated higher mean intramuscular Cr concentration compared with controls (62.1 vs 35.3 IU; P = 0.01), but there were no differences in the mean trimethylamine or lipid concentrations. In IIM patients with no intravoxel signal abnormality (9/21), the mean Cr concentration was still higher than that in healthy subjects (63.2 vs 35.3 IU; P = 0.001). Conclusions: Quantitative 3-T MRS is feasible and may supplement the role of conventional MRI in the evaluation of patients with inflammatory myopathies, especially where MRI shows no obvious muscle abnormalities.

AB - OBJECTIVE: The aim of this study was to investigate the feasibility and potential use of quantitative proton magnetic resonance spectroscopy (MRS) for determining metabolite concentrations in patients with suspected inflammatory myopathies. Materials and Methods: In this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant prospective study, 35 patients with a suspected inflammatory myopathy and 6 age-matched healthy volunteers underwent magnetic resonance imaging (MRI) (T1-weighted and short tau inversion recovery [STIR] sequences) and single-voxel MRS (point-resolved spectroscopy; repetition time/echo time, 2000/135 milliseconds; voxel size, 2.0 × 2.0 × 4.0 cm) at 3 T. The voxel was placed in a thigh muscle and targeted to one with abnormal STIR signal when possible. Absolute trimethylamine, creatine (Cr), and bulk lipid concentrations in each voxel were determined using the phantom replacement method. The MRS results of patients and healthy subjects were compared using the Wilcoxon rank sum test. Results: Twenty-one patients were diagnosed with an active idiopathic inflammatory myopathy (IIM). In 20 of these patients, MRI showed increased intramuscular STIR signal; however, the muscle where the voxel was placed was normal in 9 patients. Patients with an IIM demonstrated higher mean intramuscular Cr concentration compared with controls (62.1 vs 35.3 IU; P = 0.01), but there were no differences in the mean trimethylamine or lipid concentrations. In IIM patients with no intravoxel signal abnormality (9/21), the mean Cr concentration was still higher than that in healthy subjects (63.2 vs 35.3 IU; P = 0.001). Conclusions: Quantitative 3-T MRS is feasible and may supplement the role of conventional MRI in the evaluation of patients with inflammatory myopathies, especially where MRI shows no obvious muscle abnormalities.

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