Assessment of skeletal muscle mass in men with spinal cord injury using dual-energy X-ray absorptiometry and magnetic resonance imaging.

The purpose of this study was to determine whether the proportion of skeletal muscle in the fat-free soft tissue mass (FFST) is the same in men with spinal cord injury (SCI) and able-bodied controls. Skeletal muscle mass and FFST of the midthigh were determined by using magnetic resonance imaging and dual-energy X-ray absorptiometry, respectively, in men with long-term (>2 yr) complete SCI (n = 8) and able-bodied controls of similar age, height, and weight (n = 8). Muscle mass (1.36 +/- 0.77 vs. 2.44 +/- 0.47 kg) and FFST (1.70 +/- 0.94 vs. 2.73 +/- 0.80 kg) were lower in the SCI group than in the controls (P < 0.05), but the lower ratio of muscle to FFST in the SCI group (0.80 +/- 0.09 vs. 0.91 +/- 0.10, P < 0.05) suggested that they had a lower proportion of muscle in the FFST than in controls. This notion was supported by analysis of covariance, in that the mean muscle adjusted to the mean FFST of the groups combined was lower in the SCI group. Despite the lower proportion of muscle in the FFST of the SCI group, the relation between muscle and FFST was strong in the SCI group (r = 0.99) and controls (r = 0.96). The findings suggest a disproportionate loss of muscle in the paralyzed thighs after SCI relative to other nonfat constituents, which may be accurately estimated in men with long-term SCI by dual-energy X-ray absorptiometry if the lower proportion of muscle in the FFST (approximately 15%) is taken into account.