45 research outputs found
The effect of ageing on skeletal muscle as assessed by quantitative MR imaging: an association with frailty and muscle strength
Background: Skeletal muscles undergo changes with ageing which can cause sarcopenia that can result in frailty. Quantitative MRI may detect the muscle-deficit component of frailty which could help improve the understanding of ageing muscles.
Aims: To investigate whether quantitative MRI measures of T2, fat fraction (FF), diffusion tensor imaging and muscle volume can detect differences within the muscles between three age groups, and to assess how these measures compare with frailty index, gait speed and muscle power.
Methods: 18 âyoungâ (18â30 years), 18 âmiddle-agedâ (31â68 years) and 18 âolderâ (>â69 years) healthy participants were recruited. Participants had an MRI of their dominant thigh. Knee extension and flexion power and handgrip strength were measured. Frailty (English Longitudinal Study of Ageing frailty index) and gait speed were measured in the older participants.
Results: Young participants had a lower muscle MRI T2, FF and mean diffusivity than middle-aged and older participants; middle-aged participants had lower values than older participants. Young participants had greater muscle flexion and extension power, muscle volume and stronger hand grip than middle-aged and older participants; middle-aged participants had greater values than the older participants. Quantitative MRI measurements correlated with frailty index, gait speed, grip strength and muscle power.
Discussion: Quantitative MRI and strength measurements can detect muscle differences due to ageing. Older participants had raised T2, FF and mean diffusivity and lower muscle volume, grip strength and muscle power.
Conclusions: Quantitative MRI measurements correlate with frailty and muscle function and could be used for identifying differences across age groups within muscle
Normal values and testâretest variability of stimulated-echo diffusion tensor imaging and fat fraction measurements in the muscle
OBJECTIVES:
To assess the testâretest variability of both diffusion parameters and fat fraction (FF) estimates in normal muscle, and to assess differences in normal values between muscles in the thigh.
METHODS:
29 healthy volunteers (mean age 37 years, range 20â60 years, 17/29 males) completed the study. Magnetic resonance images of the mid-thigh were acquired using a stimulated echo acquisition mode-echoplanar imaging (STEAM-EPI) imaging sequence, to assess diffusion, and 2-point Dixon imaging, to assess FF. Imaging was repeated in 19 participants after a 30 min interval in order to assess testâretest variability of the measurements.
RESULTS:
Intraclass correlation coefficients (ICCs) for testâretest variability were 0.99 [95% confidence interval, (CI): 0.98, 1] for FF, 0.94 (95% CI: 0.84, 0.97) for mean diffusivity and 0.89 (95% CI: 0.74, 0.96) for fractional anisotropy (FA). FF was higher in the hamstrings than the quadriceps by a mean difference of 1.81% (95% CI:1.63, 2.00)%, p < 0.001. Mean diffusivity was significantly lower in the hamstrings than the quadriceps (0.26 (0.13, 0.39) x10- 3 mm2sâ1, p < 0.001) whereas fractional anisotropy was significantly higher in the hamstrings relative to the quadriceps with a mean difference of 0.063 (0.05, 0.07), p < 0.001.
CONCLUSIONS:
This study has shown excellent test-retest, variability in MR-based FF and diffusion measurements and demonstrated significant differences in these measures between hamstrings and quadriceps in the healthy thigh.
ADVANCES IN KNOWLEDGE:
Testâretest variability is excellent for STEAM-EPI diffusion and 2-point Dixon-based FF measurements in the healthy muscle. Inter- and intraobserver variability were excellent for region of interest placement for STEAM-EPI diffusion and 2-point Dixon-based FF measurements in the healthy muscle. There are significant differences in FF and diffusion measurements between the hamstrings and quadriceps in the normal muscle
Registration of Coronary MRA to DCE-MRI Myocardial Perfusion Series Improves Diagnostic Accuracy Through the Computation of Patient-Specific Coronary Supply Territories: A CE-MARC Sub-Study
Background: It is generally acknowledged that the 17-segment AHA
model provides a suitable approximation for mapping
the results of X-ray angiography onto myocardial anatomy
in a consistent way in the absence of a more exact
method. In practice, coronary anatomy varies from
patient to patient which is acknowledged as the main
limitation of the AHA model. The aim of this study was
to establish whether the generation of a patient-specific
coronary artery to perfusion segment map improved
diagnosis of myocardial ischaemia
Automated Registration of Dynamic Contrast Enhanced DCE-MRI Cardiac Perfusion Achieves Comparable Diagnostic Accuracy to Manual Motion Correction: a CE-MARC sub-study
The human interaction required for manual motion
correction/contouring of cardiac perfusion series
remains a significant obstacle to quantitative perfusion
gaining a wider acceptance in clinical practice. The use
of image registration for motion correction in perfusion
data offers a considerable time saving. Numerous registration
methods have been proposed, with evaluation
limited to the image registration accuracy. However, the
important clinical question is how do these methods
affect diagnosis? The aim of this study is to evaluate
perfusion series registration in terms of its affect on the
diagnostic accuracy of myocardial ischaemia
A Comparison of Methods for Automated Motion Correction of DCE-MRI Perfusion Datasets Evaluated in Terms of Diagnostic Accuracy: A CE-MARC sub-study
Automated mage registration in cardiac myocardial perfusion
is a necessity before quantitative perfusion can be
widely accepted in clinical practice. Increasingly complex
motion correction algorithms are being developed
to deal with cardiac motion. However, the impact of
these improvements has not been evaluated in terms of
the final clinical diagnosis. Advanced motion correction
methods are associated with increased computational
overhead and the potential of introducing subtle registration
errors, which can be hard to detect and quantify.
The aim of this study was to compare the performance
of the various automated correction methods in terms
of their impact on diagnostic accuracy
A randomised, open label, active comparator trial assessing the effects of 26âweeks of liraglutide or sitagliptin on cardiovascular function in young obese adults with type 2 diabetes
Aim
To compare the effects of a glucagonâlike peptideâ1 receptor agonist and a dipeptidyl peptidaseâ4 inhibitor on magnetic resonance imagingâderived measures of cardiovascular function.
Materials and methods
In a prospective, randomized, openâlabel, blinded endpoint trial liraglutide (1.8 mg) and sitagliptin (100âmg) were compared in asymptomatic, nonâinsulin treated young (aged 18â50âyears) adults with obesity and type 2 diabetes. The primary outcome was difference in circumferential peak early diastolic strain rate change (PEDSR), a biomarker of cardiac diastolic dysfunction 26âweeks after randomization. Secondary outcomes included other indices of cardiac structure and function, HbA1c and body weight.
Results
Seventyâsix participants were randomized (54% female, meanâÂąâSD age 44âÂą 6âyears, diabetes duration 4.4âyears, body mass index 35.3âÂąâ6.1 kgâmâ2), of whom 65% had âĽ1 cardiovascular risk factor. Sixtyâone participants had primary outcome data available. There were no statistically significant betweenâgroup differences (intentionâtoâtreat; mean [95% confidence interval]) in PEDSR change (â0.01 [â0.07, +0.06] sâ1), left ventricular ejection fraction (â1.98 [â4.90, +0.94]%), left ventricular mass (+1.14 [â5.23, +7.50] g) or aortic distensibility (â0.35 [â0.98, +0.28] mmHgâ1âĂâ10â3) after 26âweeks. Reductions in HbA1c (â4.57 [â9.10, â0.37] mmolâmolâ1) and body weight (â3.88 [â5.74, â2.01] kg) were greater with liraglutide.
Conclusion
There were no differences in cardiovascular structure or function after shortâterm use of liraglutide and sitagliptin in younger adults with obesity and type 2 diabetes. Longer studies in patients with more severe cardiac dysfunction may be necessary before definitive conclusions can be made about putative pleiotropic properties of incretinâbased therapies
Effects of Low-Energy Diet or Exercise on Cardiovascular Function in Working-Age Adults With Type 2 Diabetes: A Prospective, Randomized, Open-Label, Blinded End Point Trial
OBJECTIVE To confirm the presence of subclinical cardiovascular dysfunction in working-age adults with type 2 diabetes (T2D) and determine whether this is improved by a low-energy meal replacement diet (MRP) or exercise training.
RESEARCH DESIGN AND METHODS This article reports on a prospective, randomized, open-label, blinded end point trial with nested case-control study. Asymptomatic younger adults with T2D were randomized 1:1:1 to a 12-week intervention of 1) routine care, 2) supervised aerobic exercise training, or 3) a low-energy (âź810 kcal/day) MRP. Participants underwent echocardiography, cardiopulmonary exercise testing, and cardiac magnetic resonance (CMR) at baseline and 12 weeks. The primary outcome was change in left ventricular (LV) peak early diastolic strain rate (PEDSR) as measured by CMR. Healthy volunteers were enrolled for baseline case-control comparison.
RESULTS Eighty-seven participants with T2D (age 51 Âą 7 years, HbA1c 7.3 Âą 1.1%) and 36 matched control participants were included. At baseline, those with T2D had evidence of diastolic dysfunction (PEDSR 1.01 Âą 0.19 vs. 1.10 Âą 0.16 sâ1, P = 0.02) compared with control participants. Seventy-six participants with T2D completed the trial (30 routine care, 22 exercise, and 24 MRP). The MRP arm lost 13 kg in weight and had improved blood pressure, glycemia, LV mass/volume, and aortic stiffness. The exercise arm had negligible weight loss but increased exercise capacity. PEDSR increased in the exercise arm versus routine care (β = 0.132, P = 0.002) but did not improve with the MRP (β = 0.016, P = 0.731).
CONCLUSIONS In asymptomatic working-age adults with T2D, exercise training improved diastolic function. Despite beneficial effects of weight loss on glycemic control, concentric LV remodeling, and aortic stiffness, a low-energy MRP did not improve diastolic function