Gallien S, Mahr A, Réty F, Kambouchner M, Lhote F, Cohen P, Guillevin L
Department of Internal Medicine, UPRES EA 3409 Hôpital Avicenne, 93009 Bobigny, France.
Ann Rheum Dis. 2002 Dec;61(12):1107-9. doi: 10.1136/ard.61.12.1107.
Limb restricted polyarteritis nodosa (PAN) and PAN-type diseases such as isolated vasculitis of skeletal muscle are localised vasculitides affecting the skin, muscles, or peripheral nerves, usually of the lower limbs. These diseases often present with non-specific clinical symptoms and normal laboratory values and electromyograms. The usefulness of magnetic resonance imaging (MRI) of skeletal muscle has been poorly investigated to date.
To describe the MRI findings in the legs of three patients with limb restricted vasculitides (two PAN, one isolated vasculitis of the skeletal muscle) with histologically established muscle involvement.
MRI was carried out on calf muscles and T(2) weighted images, unenhanced T(1) weighted images, and STIR sequences were obtained.
Muscle damage resulted in oedema-like changes on MRI characterised by hyperintense signals in T(2) weighted and slow tau inversion recovery (STIR) sequences and normal unenhanced T(1) weighted sequences of one or several leg muscles.
MRI should be considered a useful complementary examination that might facilitate the recognition of limb restricted vasculitides, and possibly indicate the site for muscle biopsy. It could also be useful in monitoring the course of the disease. Future studies should also evaluate MRI for systemic PAN or other systemic vasculitides with muscle involvement.
肢体局限性结节性多动脉炎（PAN）以及诸如骨骼肌孤立性血管炎等PAN型疾病是局限于皮肤、肌肉或周围神经的局限性血管炎，通常累及下肢。这些疾病常表现为非特异性临床症状，实验室检查值及肌电图正常。迄今为止，骨骼肌磁共振成像（MRI）的作用尚未得到充分研究。
描述3例经组织学证实有肌肉受累的肢体局限性血管炎（2例PAN，1例骨骼肌孤立性血管炎）患者下肢的MRI表现。
对小腿肌肉进行MRI检查，获取T2加权像、平扫T1加权像及短tau反转恢复（STIR）序列图像。
肌肉损伤在MRI上表现为类似水肿的改变，特征为一条或多条小腿肌肉在T2加权像及STIR序列上呈高信号，平扫T1加权序列正常。
MRI应被视为一种有用的辅助检查，有助于识别肢体局限性血管炎，并可能提示肌肉活检部位。它对监测疾病进程也可能有用。未来研究还应评估MRI在系统性PAN或其他有肌肉受累的系统性血管炎中的应用。
