Gaeta Michele, Mazziotti Silvio, Minutoli Fabio, Genitori Antonino, Toscano Antonio, Rodolico Carmelo, Blandino Alfredo
Department of Radiological Sciences, University of Messina, AOU Policlinico G Martino, Messina, Italy.
Skeletal Radiol. 2009 Jun;38(6):571-8. doi: 10.1007/s00256-009-0664-3. Epub 2009 Mar 3.
The authors describe magnetic resonance (MR) findings in eight patients with histologically confirmed focal myositis.
In each patient, axial TSE T1-weighted and fast short-tau inversion recovery (STIR) images were obtained using a 1.5-T MR scanner. Three patients also underwent dynamic contrast-enhanced MR examination using a GE T1-weighted sequence. The following features were evaluated: anatomical distribution, extent of the involvement, signal intensity characteristics, dynamic enhancement pattern and outcome at follow-up examinations.
Seven of eight lesions were located in the lower extremities, one of eight in the arm; four of eight involved part of a muscle, two of eight diffusely involved a muscle and two of eight showed multifocal involvement of two or more muscles. All lesions were hyperintense on fast-STIR images: the hyperintensity was homogeneous in six of eight and inhomogeneous in two of eight. On T1-weighted unenhanced images, all lesions but two appeared isointense or slightly hypointense in comparison to normal muscles; two lesions showed a slight hyperintensity. Dynamic enhancement pattern corresponded to the type usually seen in benign soft tissue lesions. All lesions disappeared.
Focal myositis is an uncommon pseudotumour which should be considered in the differential diagnosis of muscular masses and myopathies.
作者描述了8例经组织学证实的局灶性肌炎患者的磁共振(MR)表现。
对每位患者使用1.5-T MR扫描仪获取轴位TSE T1加权和快速短反转时间反转恢复(STIR)图像。3例患者还使用GE T1加权序列进行了动态对比增强MR检查。评估了以下特征:解剖分布、受累范围、信号强度特征、动态增强模式以及随访检查结果。
8个病灶中有7个位于下肢,8个中有1个位于手臂;8个中有4个累及部分肌肉,8个中有2个弥漫性累及一块肌肉,8个中有2个显示两个或更多肌肉的多灶性受累。所有病灶在快速STIR图像上均为高信号:8个中有6个高信号均匀,8个中有2个不均匀。在T1加权未增强图像上,除2个病灶外,所有病灶与正常肌肉相比呈等信号或略低信号;2个病灶显示轻度高信号。动态增强模式与良性软组织病变中常见的类型相符。所有病灶均消失。
局灶性肌炎是一种罕见的假肿瘤,在肌肉肿块和肌病的鉴别诊断中应予以考虑。