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磁共振成像在杜氏肌营养不良症中的应用:T1 加权信号、对比摄取的定量分析以及运动的影响。

MR imaging in Duchenne muscular dystrophy: quantification of T1-weighted signal, contrast uptake, and the effects of exercise.

机构信息

Institute of Human Genetics, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, United Kingdom.

出版信息

J Magn Reson Imaging. 2009 Nov;30(5):1130-8. doi: 10.1002/jmri.21941.

Abstract

PURPOSE

To quantify the differences between normal and corticosteroid-treated Duchenne muscular dystrophy (DMD) lower limb muscle using signal intensity measurements on T(1)-weighted and gadolinium contrast-enhanced images and by measurement of muscle T(2) values, and to investigate the effect of exercise.

MATERIALS AND METHODS

Eleven ambulant boys with DMD were imaged at 3 Tesla (T(1)-weighted, gadolinium enhancement and T(2) measurement) before stepping exercise and again (gadolinium, T(2) measurement) 4 days later and were compared with five healthy controls imaged 4 days before and after stepping exercise. Muscle region-of-interest signal intensities were referenced to external oil and gadolinium phantoms.

RESULTS

DMD thigh muscle T(2) values were significantly higher than normal values with the exception of the gracilis muscle. Eight of nine muscles studied showed a significant increase in T(1)-w signal intensity in DMD as compared to normal muscle, suggestive of increased fat infiltration in DMD muscle. In the DMD boys, an exercise effect (increased contrast enhancement) was only seen for the tibialis anterior muscle.

CONCLUSION

Referenced signal intensity measurements may be used to quantify differences between dystrophic and normal muscle without T(1) mapping. Stepping exercise does not have a large impact on subsequent MR imaging of dystrophic muscle.

摘要

目的

利用 T1 加权和钆增强图像的信号强度测量值以及肌肉 T2 值的测量值,定量比较正常和皮质类固醇治疗的杜氏肌营养不良症(DMD)下肢肌肉之间的差异,并研究运动的影响。

材料与方法

在 3T(T1 加权、钆增强和 T2 测量)下对 11 名可走动的 DMD 男孩进行成像,在踏步行走前进行成像,在 4 天后再次进行成像(钆增强、T2 测量),并与 5 名健康对照者在踏步行走前和后 4 天进行的成像进行比较。肌肉 ROI 信号强度参照外部油和钆标准。

结果

DMD 大腿肌肉 T2 值除了比目鱼肌外均明显高于正常值。在 DMD 中,与正常肌肉相比,研究的 9 块肌肉中有 8 块的 T1w 信号强度显著增加,提示 DMD 肌肉中的脂肪浸润增加。在 DMD 男孩中,仅前胫骨肌出现增强对比(增强)的运动效应。

结论

参考信号强度测量值可用于定量比较正常和 DMD 肌肉之间的差异,而无需进行 T1 映射。踏步行走对随后的 DMD 肌肉磁共振成像影响不大。

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