Peters S A, Köhler C, Schara U, Hohendahl J, Vorgerd M, Nicolas V, Heyer C M
Institut für Diagnostische Radiologie, Interventionelle Radiologie und Nuklearmedizin, BG Kliniken Bergmannsheil, Ruhr-Universität Bochum, Germany.
Klin Padiatr. 2008 Jan-Feb;220(1):37-46. doi: 10.1055/s-2007-970587. Epub 2007 Dec 21.
Myopathies present with a broad diagnostic spectrum which may ultimately require muscle biopsy. MRI has been established as a non-invasive method in diagnosing adult myopathies; not only does MRI reveal characteristic findings which point in a diagnostic direction, but also aids in determining optimal biopsy sites and controlling therapeutic interventions. Muscle MRI is increasingly finding application to pediatric myopathies, especially dystrophies and myositides. The following paper serves to illustrate the use of MRI using exemplary clinical vignettes.
PATIENTS/METHODS: From 1999 until 2006, 180 children with myopathies of unknown aetiology, ages 10 months to 18 years, were examined with a standardised MRI protocol (axial T1-SE and T2-weighted TIRM sequences). The protocol included imaging of the lower extremities whereas sequences displaying the upper extremities were only acquired in selected patients. Furthermore, intravenous contrast agent was only administered in selected children.
All investigations could be performed without sedation due to an examination time of 12 to 15 minutes. The illustrated cases of limb-girdle muscular dystrophy, Duchenne's muscular dystrophy, dermatomyositis, pyomyositis, and chronic neurogenic disease with secondary myopathy all showed disease-characteristic MRI patterns which substantially helped to reach the ultimate diagnosis.
Muscle MRI is a non-invasive and effective instrument in helping to diagnose pediatric myopathies of unknown aetiology. It may facilitate muscle biopsy and serves to control therapeutical effects and disease course. Furthermore, muscle MRI may be applicated even to children of less than 4 years of age without sedation.
肌病的诊断范围广泛，最终可能需要进行肌肉活检。MRI已被确立为诊断成人肌病的一种非侵入性方法；MRI不仅能显示指向诊断方向的特征性表现，还有助于确定最佳活检部位并监测治疗干预效果。肌肉MRI在儿科肌病，尤其是营养不良和肌炎中的应用越来越广泛。以下论文旨在通过典型临床案例说明MRI的应用。
患者/方法：1999年至2006年，对180例病因不明的肌病患儿进行了标准化MRI检查（轴位T1加权自旋回波序列和T2加权快速反转恢复序列），年龄在10个月至18岁之间。该检查方案包括下肢成像，而仅对部分患者采集了显示上肢的序列。此外，仅对部分儿童使用了静脉造影剂。
由于检查时间为12至15分钟，所有检查均无需镇静即可完成。所展示的肢带型肌营养不良、杜氏肌营养不良、皮肌炎、脓性肌炎以及继发肌病的慢性神经源性疾病病例均显示出具有疾病特征的MRI表现，这对最终诊断有很大帮助。
肌肉MRI是一种非侵入性且有效的工具，有助于诊断病因不明的儿科肌病。它可以促进肌肉活检，并用于监测治疗效果和疾病进程。此外，肌肉MRI甚至可以应用于4岁以下无需镇静的儿童。
