Relationships between MR diffusion-weighted images, pathology, clinical findings, and genetics in patioents with muscular dystrophy.

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We have investigated the relationships between clinical and MR imaging findings, especially focusing on intensity changes of diffusion-weighted images of the legs. 25 patients with muscular dystrophy ; 15 patients with myotonic type, 4 patients with Becker type, 6 patients with Lomb-girdle type muscular dystrophy. Their ages were from 15 to 55 years old(mean age ; 36 years old), 17 men and 8 women. T2-weighted images with fat suppression showed multiple or diffuse high signals and diffusion-weighted images represented high signals at the same areas. There were correlations between them. ADC map also showed high intensity, which mean the T2 high signal represented T2 shine-through, probably due to edematous changes. There were correlations between high signals on T2- and diffusion-weighted images and clinical symptoms and serum creatine kinase. The cause of myotonic dystrophy is overextension of CTG(cytosine-thymidine-guanine) trinucleotide on q13.3 of chromosome 19. The number of the triplet extension was not correlated with MR T2 high signals. On the other hand, the patients with muscular dystrophy have a high risk for venous thrombosis of the legs. This study also proved the merit of diffusion-weighted images on MR. Acute thrombosis was shown as bright signal on diffusion-weighted images and low or isointensity on ADC map. It is useful to detect the thrombosis without contrast media which has sometimes induce side effect.