Magnetic resonance imaging of skeletal muscles in sporadic inclusion body myositis
Magnetic resonance imaging of skeletal muscles in sporadic inclusion body myositis
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DOI：
10.1093/rheumatology/ker001
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发表时间：
2011-06-01
期刊：
影响因子：
5.5
通讯作者：
Badrising, Umesh A.
中科院分区：
文献类型：
--
作者：
Cox, Fieke M.;Reijnierse, Monique;Badrising, Umesh A.
目标。分析一大群散发性IBM(SIBM)患者的上肢和下肢肌肉MRI对sIBM的诊断价值。研究对象为32例sIBM患者。对68块上肢和下肢肌肉的磁共振(MR)参数进行了评估，包括肌肉萎缩、脂肪渗透和炎症。这些发现与病程、虚弱程度和血清肌酸激酶(SCK)水平相关。脂肪渗透远比炎症更常见。脂肪渗入最多的肌肉是指深屈肌、大腿前肌和小腿所有肌肉，以腓肠肌内侧为主。与其他股四头肌和大腿内收肌相比，股直肌相对宽大。炎症在总体上是常见的，但个别很稀少，78%的患者存在炎症，每个患者的中位数为两块发炎的肌肉。脂肪浸润量与疾病严重程度、病程和sCK之间存在统计学意义上的相关性。我们提供了sIBM的MRI的详细描述，并显示了肌肉受累的明显模式。相对严重的腓肠肌内侧肌室受累，合并股直肌相对疏松或FDP受累，可提示sIBM。对于临床怀疑明确，但缺乏强制性肌肉活检特征的选定患者，MRI可以帮助诊断。
Objective. To analyse whether MRI of upper and lower extremity muscles in a large patient group with sporadic IBM (sIBM) is of additional value in the diagnostic work-up of sIBM.Methods. Thirty-two sIBM patients were included. Magnetic resonance (MR) parameters evaluated in 68 muscles of upper and lower extremity were muscle atrophy, fatty infiltration and inflammation. These findings were correlated with disease duration, weakness and serum creatine kinase (sCK) levels.Results. Fatty infiltration was far more common than inflammation. Muscles most frequently infiltrated with fat were the flexor digitorum profundus (FDP), anterior muscles of the upper leg and all muscles of the lower leg, preferentially the medial part of the gastrocnemius. The rectus femoris was relatively spared compared with other quadriceps muscles as well as the adductors of the upper leg. Inflammation was common in general, but individually sparse, present in 78% of the patients with a median of two inflamed muscles per patient. A statistically significant correlation was found between the amount of fatty infiltration and disease severity, disease duration and sCK.Conclusion. We provide a detailed description of the MRI in sIBM and show a distinct pattern of muscle involvement. Relatively severe affliction of the medial compartment of the gastrocnemius, combined with relative sparing of the rectus femoris or involvement of the FDP can be indicative of sIBM. MRI can contribute to the diagnosis in selected patients with clear clinical suspicion, but lacking the mandatory set of muscle biopsy features.