Juvenile idiopathic inflammatory myopathies: the value of magnetic resonance imaging in the detection of muscle involvement.
Juvenile idiopathic inflammatory myopathies: the value of magnetic resonance imaging in the detection of muscle involvement.
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DOI：
10.1590/s1516-31802000000200002
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发表时间：
2000-03-02
期刊：
影响因子：
--
通讯作者：
Lederman, H
中科院分区：
文献类型：
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作者：
Hilario, M O;Yamashita, H;Lederman, H
背景：当前与青少年特发性炎症性肌病相关的主要挑战之一是寻找高度敏感和特异的非侵入性诊断和随访方法。目的：我们研究的目的是描述典型的磁共振成像结果并调查该方法在检测青少年皮肌炎和青少年系统性红斑狼疮患者活动性肌肉疾病中的有用性。设计：横向研究，盲法评估。单位：大学转诊单位（联邦大学圣保罗/保利斯塔医学院儿科系儿科风湿病学部分）。皮肌炎患者13例（女孩9例），12例儿童系统性红斑狼疮患者和10例正常儿童（5例女孩）。由两名放射科医师对臀大肌、四头肌、内收肌和屈肌进行定性和定量分析并进行评价，所有临床信息均不知情。结果：患者的不同肌群表现为不均匀的受累。皮肌炎患者表现为急性和慢性肌肉病变，而狼疮患者仅表现为慢性肌肉病变，尤其是萎缩。在皮肌炎组中，主要的改变被发现在臀肌和屈肌区域（信号强度和脂肪替代）。结论：定性和定量共振分析是有用的，在检测临床活动性疾病皮肌炎患者的信号强度增加。
CONTEXT: One of the major current challenges related to juvenile idiopathic inflammatory myopathy is the search for highly sensitive and specific non-invasive methods for diagnosis as well as for follow-up.OBJECTIVES: The aim of our study was to describe typical magnetic resonance imaging findings and to investigate the usefulness of this method in detecting active muscle disease in juvenile dermatomyositis and juvenile systemic lupus erythematosus patients.DESIGN: Transverse study, blinded assessment.SETTING: University referral unit (Pediatric Rheumatology section, Department of Pediatrics, Universidade Federal de Sao Paulo / Escola Paulista de Medicina).SAMPLE: Thirteen patients (9 girls) with dermatomyositis, as well as 13 patients (12 girls) with juvenile systemic lupus erythematosus and 10 normal children (5 girls), were enrolled in the study.MAIN MEASUREMENTS: Qualitative and quantitative analyses of gluteus maximus, quadriceps, adductors and flexors were performed and evaluated by two radiologists, blinded to all clinical information. Spin-echo in T1, DP, T2 and IR was used in all MRI images.RESULTS: The different muscle groups presented non-uniform involvement in the patients. The patients with dermatomyositis presented acute and chronic muscular alterations, while those with lupus presented only chronic myopathy, especially atrophy. In the dermatomyositis group, the major alterations were found in the gluteus and flexor regions (signal intensity and fat replacement). The signal intensity was increased in all acute myopathies.CONCLUSION: The qualitative and quantitative resonance analyses are useful in detecting clinically active disease in patients with dermatomyositis.