Muscle T2 and fat-fraction are two promising metrics for sensitive measures of early disease-related changes in muscle for use in clinical trials. However, fat has a longer T2 than water in muscle and masks underlying increases in water T2 due to muscle oedema. The IDEAL-CPMG sequence with appropriate image-data processing produces a T2-water map uncontaminated by the fat signal. This sequence was acquired in healthy volunteers and two different muscular dystrophy disease types. It was found that elevated T2-water may be a predictor of later progression to fatty-atrophy in muscle, supporting the value of future longitudinal studies to test this.
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