One diagnostic criterion for metabolic syndrome is obesity from the accumulation of visceral fat; others include abdominal circumference and area of visceral fat as measured by computed tomography (CT) at the umbilical level. We evaluated visceral fat using frequency-selective excitation magnetic resonance (MR) imaging SPAIR (spectral attenuation with inversion recovery) water suppression THRIVE (3D T1-high resolution isotropic volume examination). Fifty of 70 slices with 2-mm interval were used to render and measure volume of visceral fat ranging within 10 cm of the umbilicus; the area of visceral fat at the umbilical level was also measured. Imaging was completed using breath hold within 14 s. Image processing was easier than using CT.
We attempted to measure the area and volume of visceral fat using magnetic resonance (MR) imaging to avoid radiation exposure. We used water suppression-spectral attenuation with inversion recovery (WS-SPAIR) as prepulses and conducted T 1 high-resolution isotropic volume examination (THRIVE). 1 Image processing software can be used to estimate the area and volume of fat and separate the fat and water signals at a visually optimal threshold in the MR image, which requires contrast enhancement between intestinal contents and visceral fat. In 14 volunteers, we evaluated WS-SPAIR and water suppressionspectral presaturation with inversion recovery (WS-SPIR) with respect to the relationship between the ‰ip angle of THRIVE and signal contrast. We used ‰ip angles of 59 , 109 , and 209 . The minimum threshold that allowed exclusion of intestinal contents from the masked region was determined for each technique. The volume and area of the masked region, which included subcutaneous fat, were measured at the umbilicus level. Both volume and area increased with a smaller ‰ip angle. The masked region was larger with WS-SPIR-THRIVE (‰ip angle 59 ). The size of the masked region was determined according to the minimum threshold that allowed exclusion of the intestinal contents from the masked region, expressing the contrast between the intestinal contents and fat in a relative manner. It was speculated that by separating the signals at the threshold, WS-SPIR-THRIVE (‰ip angle 59 ) was a more suitable technique for measuring the area and volume of visceral fat.
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