Paraspinal back muscles in asymptomatic volunteers: quantitative and qualitative analysis using computed tomography (CT) and magnetic resonance imaging (MRI)

Eun Kyung Khil,Jung-Ah Choi,Sabrilhakim Sidek,Eunjin Hwang,Il Choi

doi:10.1186/s12891-020-03432-w

Abstract

BackgroundTo evaluate paraspinal back muscles of asymptomatic subjects using qualitative and quantitative analysis on CT and MRI and correlate the results with demographic data.MethodsTwenty-nine asymptomatic subjects were enrolled prospectively (age: mean 34.31, range 23–50; 14 men, 15 women) from August 2016 to April 2017. Qualitative analysis of muscles was done using Goutallier’s system on CT and MRI. Quantitative analysis entailed cross sectional area (CSA) on CT and MRI, Hounsfield unit (HU) on CT, fat fraction using two-point Dixon technique on MRI. Three readers independently analyzed the images; intra- and inter-observer agreements were measured. Linear regression and Spearman’s analyses were used for correlation with demographic data.ResultsCSA values were significantly higher in men (p < 0.001). Fat fraction was higher (22.53% vs. 14.35%) and HU lower (36.00 vs. 47.43) in women (p < 0.001). Intra- and inter-observer reliabilities of the two methods were greater than 0.8, except for CSA of L5/S1 on MRI; however, regarding quantitative analysis, decreasing HU and increasing fat fraction were correlated with increasing age, female gender and lower lumbar segment (p < 0.001).ConclusionMRI and CT can be reliably used for qualitative and quantitative analysis of paraspinal back muscles, regarding fat content. Fat fraction and HU showed highest reliabilities.

Highlights

To evaluate paraspinal back muscles of asymptomatic subjects using qualitative and quantitative analysis on Computed tomography (CT) and Magnetic resonance imaging (MRI) and correlate the results with demographic data
In this study, we analyzed the lumbar paraspinal muscles both quantitatively and qualitatively on CT and MRI at all lumbar segments in young asymptomatic adults, regarding reliability of these methods and analyzed the correlation with demographic variables, especially regarding fat content. Study population This was a prospective study of asymptomatic healthy volunteers from August 2016 to April 2017; they were recruited from a health screening program, which usually gives the choice of having CT or MRI performed upon the subjects’ choice; Institutional Review Board approval and written informed consent were obtained
Regarding demographic data, height, weight, and body mass index (BMI) were significantly higher in males as expected (Table 2)

Summary

Introduction

To evaluate paraspinal back muscles of asymptomatic subjects using qualitative and quantitative analysis on CT and MRI and correlate the results with demographic data. Some quantitative studies of paraspinal muscles have used the ratio of CSAs on CT or MRI [3, 5, 14,15,16,17]. It may be difficult to generalize CSAs to represent degenerative changes in lumbar paraspinal muscles because of differences in people’s body composition. There have been studies evaluating functional CSA (fCSA), measuring areas without fatty changes, or total CSAs of the paraspinal muscles [3, 7, 16,17,18]. We used the two-point dixon technique because fat fraction (FF) can readily be obtained on a clinical scanner within reasonable time [21]

Methods

Results

Discussion

Conclusion