踝关节骨折后小腿固定期间肌肉萎缩的纵向 MRI 研究。

A longitudinal MRI study of muscle atrophy during lower leg immobilization following ankle fracture.

机构信息

Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, Scotland, United Kingdom.

出版信息

J Magn Reson Imaging. 2012 Mar;35(3):686-95. doi: 10.1002/jmri.22864. Epub 2011 Nov 1.

DOI:10.1002/jmri.22864

PMID:22045592

Abstract

PURPOSE

To investigate MRI biomarkers of muscle atrophy during cast immobilization of the lower leg.

MATERIALS AND METHODS

Eighteen patients (8 male, 10 female), who had one lower leg immobilized in a cast, underwent 3.0 Tesla (T) MR imaging 5, 8, 15, 29, and 43 days after casting. Measurements were made on both lower legs of total muscle volume. Cross-sectional area (CSA), fractional water content, and T(2) were measured in tibialis anterior (TA), gastrocnemius medialis (GM) and lateralis (GL) and soleus (SOL). Fiber pennation angle was measured in GM.

RESULTS

Total muscle volume decreased by 17% (P < 0.001) over the 6 weeks of immobilization. The greatest loss in CSA (mean[SD]) was seen in GM (-23.3(8.7)%), followed by SOL (-19.0(9.8)%), GL (-17.1(6.5)%), and TA (-10.7(5.9)%). Significant reductions of CSA were also detectable in the contra-lateral leg. T(2) increased in all muscles: TA 27.0(2.5) ms to 29.6(2.8) ms (P < 0.001), GM 34.6(2.9) ms to 39.8(5.4) ms (P < 0.001) and SOL 34.4 (2.9) ms to 44.9(5.9) ms (P < 0.001). Small reductions were found in fractional water content. Pennation angle decreased in the cast leg (P < 0.001).

CONCLUSION

Quantitative MR imaging can detect and monitor progressive biochemical and biophysical changes in muscle during immobilization.

摘要

目的

研究小腿石膏固定期间肌肉萎缩的 MRI 生物标志物。

材料与方法

18 名患者（8 名男性，10 名女性），一条小腿被石膏固定，在打石膏后 5、8、15、29 和 43 天分别进行 3.0T（T）磁共振成像。对双侧小腿的总肌肉体积进行测量。在胫骨前肌（TA）、腓肠肌内侧（GM）和外侧（GL）和比目鱼肌（SOL）中测量横截面积（CSA）、分水量和 T(2)。在 GM 中测量肌纤维羽状角。

结果

6 周固定期内，总肌肉体积减少 17%（P<0.001）。CSA 的最大损失（平均值[标准差]）见于 GM（-23.3[8.7]%），其次是 SOL（-19.0[9.8]%）、GL（-17.1[6.5]%）和 TA（-10.7[5.9]%）。对侧肢体也可检测到 CSA 的显著减少。所有肌肉的 T(2)均增加：TA 从 27.0(2.5)ms 增加到 29.6(2.8)ms（P<0.001），GM 从 34.6(2.9)ms 增加到 39.8(5.4)ms（P<0.001），SOL 从 34.4(2.9)ms 增加到 44.9(5.9)ms（P<0.001）。分水量略有减少。羽状角在石膏腿中减小（P<0.001）。