Table 1 A non-systematic summary of methods across investigations describing cervical spine muscle analysis using magnetic resonance imaging (MRI)
Citation | Reliability | MRI Sequence | Slice Selection | Muscles of Interest | ROI Selection | Fat Detection | Measure |
|---|---|---|---|---|---|---|---|
Elliott et al., 2006 [1] Elliott et al., 2008 [7] Elliott et al., 2009 [78] Elliott et al., 2011 [2] | Inter-rater (0.94) Intra-rater (0.94) | T1 | Axial images aligned parallel to C2–3 disc; Measured at single slice per level C3-C7; most cephalad slice of each vertebral body selected | MF SSCerv SSCap SpCap UT | Manual | Quantitative Pixel Intensity | Fat Infiltration %MFI = (muscle signal)/(fat signal)*100 |
Fernandez De Las Penas et al., 2007 [79] | Inter-rater (0.80–0.98) | T1 | Axial images aligned parallel to C2–3 disc; measured at single slice per level; most cephalad slice of each vertebral body selected | SSCap SpCap | Manual | N/A | CSA |
Elliott et al., 2007 [47] | Intra-rater (0.84–0.99) Inter-rater (0.89–0.96) | T1 | Axial images aligned parallel to C2–3 disc; measured at single slice per level C3-C7; most cephalad slice of each vertebral body selected | MF SSCerv SSCap SpCap UT | Manual | N/A | CSA |
Okada et al., 2011 [80] Matsumoto et al., 2012 [12] | Intra- rater (0.90) Inter-rater (0.844) | T2 | Measurements from a single axial slice aligned parallel to each IVD C3–4, C4–5, and C5–6 | MF SSCerv SSCap SpCap | Manual | N/A | CSA |
Ulbrich et al., 2012 [14] | Inter-rater (0.79–0.98) | STIR | Axial images aligned perpendicular to the vertebral body in the middle of a 20-slice slab. 2 or 3 overlapping slabs used; measurements from single slice per vertebral level C2, C4, and C5 | Deep Extensors All Extensors SCM | Manual | N/A | CSA |
Elliott et al., 2013 [41] | Inter-rater for fat-water sequence (0.83–0.99) | T1 vs. Dixon | Axial images aligned perpendicular to the spinal cord at the C2-C3 IVD; measurement from single slice per vertebral level C3-C7 | MF | Manual | Quantitative Pixel Intensity vs. Fat (F)-Water (W) | Fat Infiltration % MFI = (fat signal)/(fat signal + water signal) *100 |
Elliott et al., 2014 [8] | From Elliott et al., 2007 [47] for CSA Intra- rater (0.84–0.99) Inter-rater (0.89–0.96) | T1 | Axial images aligned parallel to C2–3 IVD; measurements from single slice crossing IVDs C2-C3 and C5-C6 | MF SSCerv SSCap SpCap LCap/LCol SCM | Manual | Quantitative Pixel Intensity | Fat Infiltration %MFI = (fat signal)/(fat signal + water signal)*100 CSA |
Elliott et al., 2015 [3] | Not reported | Dixon | Measurements from single slice per vertebral level C3-C7; alignment and slice selection not reported | MF | Manual | Fat-Water | Fat Infiltration %MFI = (fat signal)/(fat signal + water signal)*100 |
Abbott et al., 2015 [6] | Intra-rater (0.98) Inter-rater (0.93) | Dixon | Measurements averaged over 5 slices for each vertebral level C3-C7; Slab alignment not reported. | MF + SSCerv (combined) | Manual with automatic quartile measure | Fat-Water | Fat Infiltration %MFI = (fat signal)/(fat signal + water signal)*100 |
Karlsson et al., 2016 [5] | For muscle fat Intra-rater (0.81–0.93) Inter-rater (0.82–0.97) | Dixon | Axial images aligned parallel to vertebral segments; measurements averaged over 5 slices for each vertebral level C4-C7 | MF | Manual | Fat-Water | Fat Infiltration %MFI = (fat signal)/(fat signal + water signal)*100 CSA |
Au et al., 2016 [57] | Not reported | T1 | Axial images aligned parallel to C2–3 intervertebral disc; 3D reconstruction | IC, IS, LS, LoCap, LoC, LCap, LCol, MF, LoCap, LoCerv, SSCap, SSCerv, SCM, UT | Manual | N/A | N/A |
Fortin et al., 2017 [27] Fortin et al., 2018 [81] | From [81]:Intra-rater (0.83–0.99) Inter-rater (0.38–0.98) | T2 | 3D multiplanar reconstruction to align images perpendicular to muscle mass; measurements from a single slice per IVD C2–3 through C6–7 | MF SSCerv SSCap SpCap | Manual ROI with semi-automatic muscle/fat thresholding technique | Gray-scale threshold technique to calculate CSA of fat within total muscle CSA; gray-scale range determined for each slice individually | Total CSA Functional CSA (FCSA) (= fat free area) Fatty Infiltration = FCSA/Total CSA |
Inoue et al., 2012 [82] | Intra-rater (0.85) | T1 T2-fat suppression | Measured from single slice per level; most caudal slice of C3 and most cephalad slice of each vertebral body C4-C7 selected; slab alignment not reported | MF | Manual | Lean muscle CSA: ROI drawn on T1-W images not including fat Total muscle CSA: ROI drawn on fat suppression T2-W image including fat Fat CSA = Total CSA – Lean Muscle CSA | Fatty Infiltration = (Fat CSA)/(Total muscle CSA) |
Mitsutake et al., 2016 [83] | Intra-rater 0.85–0.94 Inter-rater (0.84–0.89) | T1 | Measured from single, most cephalad slice at level of injury (C4, C5, or C6) | MF | Manual | Quantitative Pixel Intensity | MFI index = Muscle signal/Fat signal |
Abbott et al., 2017 [67] | Intra-rater (0.77–0.88) Inter-rater (0.67–0.82) | Dixon | Axial images aligned parallel to each IVD; measured from 5 slices across each vertebral level C4-C7 | MF | Manual | Qualitative grading (0, 1, 2) for each 8 regions within visualized ROI on fat image | Fat Infiltration MFI Score: 0 = no or marginal fat 1 = light fat 2 = distinct fat Sum of scores Total # of 2’s |
Choi et al., 2016 [84] | Inter-rater (0.82) | T1 | Axial images aligned parallel to the inferior end plate of each vertebral body from C4–5 to C7-T1; measured from single slice per vertebral level | Flexor Group: LCap + LCol Extensor Group: MF + SSCerv | Manual | N/A | CSA Normalized Extensor CSA = (Extensor Muscle CSA)/(Vertebral body CSA) *100 |
Cagnie et al., 2009 [85] | Inter-rater (0.91) | T1 | Measured from a single slice aligned parallel IVD at C4-C5 | LCap LCol UT LS SpCap SSCerv MF | Manual | Quantitative Pixel Intensity | Muscle/Fat Index = Muscle signal/Fat signal |
Uthaikup et al., 2017 [86] | Intra-rater (0.75–0.96) Inter-rater (0.84–0.99) | T1 | Axial images aligned parallel to the C2–3 IVD; measured from a single slice at each vertebral level C2-C3 | MF SSCap SpCap LCap LCol SCM | Manual | Quantitative Pixel Intensity | Fat Infiltration MFI = Muscle signal/Fat signal |