Moratalla Mónica Ballesta, Braun Petra, Fornas Guillermina Montoliu
Department of Radiology, La Fe Hospital, Avenida Campanar, 21, 46009 Valencia, Spain.
Eur J Radiol. 2008 Feb;65(2):311-5. doi: 10.1016/j.ejrad.2007.03.033. Epub 2007 May 4.
Rhabdomyolysis is a common disorder resulting from a large variety of causes. We describe the MRI features and their importance for diagnosis and treatment.
Between 2003 and 2006, four male patients (age range: 25-33 years) with rhabdomyolysis were studied via 1.5 T MRI (GE, Siemens). In all the patients, T1- and T2-weighted sequences with and without fat suppression, short tau inversion recovery (STIR) and gradient-echo sequences were obtained in axial, coronal and sagittal planes. In one patient, contrast material was given.
Two patients presented rhabdomyolysis due to drug abuse, one due to intense exercise and the last one due to long unconsciousness with compression of the paravertebral musculature. Two patients had acute kidney failure. The affected muscles showed an increased signal intensity on T2-weighted and STIR sequences and decreased on T1-weighted sequences. In one patient, intramuscular hemorrhage was observed on T1-weighted and gradient-echo sequences. In the patient with kidney failure, a globular swelling of the kidney with alteration of the corticomedullary differentiation on T2-weighted sequences with fat saturation and hypointensity of the renal medulla on T1-weighted contrast enhanced images was found.
Immediate recognition of rhabdomyolysis is important to prevent late complications. MRI is the method of choice to evaluate the distribution and extension of the affected muscles, especially when fasciotomy is considered for treatment. Even though the MRI findings are non-specific, the sensitivity in the detection of muscle involvement is higher than CT or US.
横纹肌溶解症是一种由多种原因引起的常见病症。我们描述了其MRI特征及其对诊断和治疗的重要性。
2003年至2006年间，对4例横纹肌溶解症男性患者（年龄范围：25 - 33岁）进行了1.5T MRI（GE，西门子）检查。所有患者均在轴向、冠状面和矢状面获得了有和没有脂肪抑制的T1加权和T2加权序列、短tau反转恢复（STIR）序列以及梯度回波序列。1例患者使用了对比剂。
2例患者因药物滥用导致横纹肌溶解症，1例因剧烈运动，最后1例因长时间昏迷伴椎旁肌肉受压。2例患者出现急性肾衰竭。受累肌肉在T2加权和STIR序列上信号强度增加，在T1加权序列上信号强度降低。1例患者在T1加权和梯度回波序列上观察到肌肉内出血。在肾衰竭患者中，在脂肪饱和的T2加权序列上发现肾脏呈球状肿胀，皮髓质分界改变，在T1加权对比增强图像上肾髓质呈低信号。
及时识别横纹肌溶解症对于预防晚期并发症很重要。MRI是评估受累肌肉分布和范围的首选方法，尤其是在考虑进行筋膜切开术治疗时。尽管MRI表现不具有特异性，但在检测肌肉受累方面的敏感性高于CT或超声。
