Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229-3039, USA,
Pediatr Radiol. 2013 Oct;43(10):1327-35. doi: 10.1007/s00247-013-2696-z. Epub 2013 May 12.
Prior reports focus primarily on muscle fatty infiltration in Duchenne muscular dystrophy (DMD). However, the significance of muscle edema is uncertain.
To evaluate the frequency and degree of muscle fat and edema, and correlate these with clinical function.
Forty-two boys (ages 5-19 years) with DMD underwent pelvic MRI. Axial T1- and fat-suppressed T2-weighted images were evaluated to grade muscle fatty infiltration (0-4) and edema (0-3), respectively. Degree and frequency of disease involvement were compared to clinical evaluations.
Gluteus maximus had the greatest mean fatty infiltration score, followed by adductor magnus and gluteus medius muscles, and had the most frequent and greatest degree of fatty infiltration. Gluteus maximus also had the greatest mean edema score, followed by vastus lateralis and gluteus medius muscles. These muscles had the most frequent edema, although the greatest degree of edema was seen in other muscles. There was correlation between cumulative scores of fatty infiltration and all clinical evaluations (P < 0.05).
In DMD, the muscles with the most frequent fatty infiltration had the greatest degree of fatty infiltration and correlated with patient function. However, the muscles with the most frequent edema were different from those with the greatest degree of edema. Thus, edema may not predict patient functional status.
先前的报告主要集中在杜氏肌营养不良症（DMD）中的肌肉脂肪浸润。然而，肌肉水肿的意义尚不确定。
评估肌肉脂肪和水肿的频率和程度，并将其与临床功能相关联。
42 名 DMD 男孩（年龄 5-19 岁）接受了骨盆 MRI 检查。对轴向 T1 和脂肪抑制 T2 加权图像进行评估，分别对肌肉脂肪浸润（0-4 级）和水肿（0-3 级）进行分级。比较疾病的程度和频率与临床评估的结果。
臀大肌的平均脂肪浸润评分最高，其次是内收大肌和臀中肌，且脂肪浸润的频率最高，程度最严重。臀大肌的平均水肿评分也最高，其次是股外侧肌和臀中肌。这些肌肉的水肿最频繁，但水肿程度最大的肌肉却不同。脂肪浸润的累积评分与所有临床评估均相关（P<0.05）。
在 DMD 中，脂肪浸润最频繁的肌肉脂肪浸润程度最高，与患者的功能相关。然而，水肿最频繁的肌肉与水肿程度最大的肌肉不同。因此，水肿可能无法预测患者的功能状态。
