Abstract
Excess bone marrow adiposity may have a negative effect on bone growth and development. The aim of this study was to determine whether a procedure using standard T1-weighted magnetic resonance images provides an accurate estimate of bone marrow fat in children with typical development and in children with mild spastic cerebral palsy (CP; n = 15/group; 4–11 y). Magnetic resonance imaging was used to acquire T1-weighted images. It was also used to acquire fat and water images using an iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) technique. Bone marrow fat volume and fat fraction in the middle-third of the tibia were determined using the standard T1-weighted images (BMFVT1 and BMFFT1, respectively) and the fat and water images (BMFVIDEAL and BMFFIDEAL, respectively). In both groups, BMFVT1 was highly correlated with (both r > 0.99, p < 0.001) and not different from (both p > 0.05) BMFVIDEAL. In both groups, BMFFT1 was moderately correlated with (both r = 0.71, p < 0.01) and not different from (both p > 0.05) BMFFIDEAL. There was no group difference in BMFVT1 or BMFVIDEAL (both p > 0.05). BMFFIDEAL was higher in children with CP (p < 0.05), but there was no group difference in BMFFT1 (p > 0.05). We conclude that a procedure using standard T1-weighted magnetic resonance images can produce estimates of bone marrow fat volume similar to estimates from the IDEAL technique in children. However, it is less sensitive to variation in the bone marrow fat fraction.
Highlights
Excess bone marrow adiposity may have a negative effect on bone growth and development
No between group differences were detected between typically developing children and children with cerebral palsy (CP) except for height percentile and body mass percentile, which were significantly lower in children with CP
There was no difference between BMFVT1 and BMFVIDEAL in children with CP (d = 0.144, p = 0.978) or in typically developing children (d = 0.041, p > 0.99)
Summary
Excess bone marrow adiposity may have a negative effect on bone growth and development. The aim of this study was to determine whether a procedure using standard T1-weighted magnetic resonance images provides an accurate estimate of bone marrow fat in children with typical development and in children with mild spastic cerebral palsy (CP; n = 15/group; 4–11 y). Bone marrow fat volume and fat fraction in the middle-third of the tibia were determined using the standard T1-weighted images (BMFVT1 and BMFFT1, respectively) and the fat and water images (BMFVIDEAL and BMFFIDEAL, respectively). The development of new magnetic resonance imaging (MRI) techniques during the past twenty years, such as proton magnetic resonance spectroscopy (MRS) and iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL)[15], which are forms of chemical shift imaging, allow for the quantification of bone marrow fat in humans. The purpose of this study was to determine whether a method using standard T1-weighted magnetic resonance images provides an accurate estimate of bone marrow fat in children who are typically developing, and in children with CP, a population that has been shown to have elevated bone marrow fat compared to their typically developing peers[9]
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