Lamminen A E, Hekali P E, Tiula E, Suramo I, Korhola O A
Department of Diagnostic Radiology, University Central Hospital, Helsinki, Finland.
Br J Radiol. 1989 Apr;62(736):326-30. doi: 10.1259/0007-1285-62-736-326.
Fifteen patients with acute rhabdomyolysis were evaluated with low field magnetic resonance (MR) imaging and the results compared with those obtained using computed tomography (CT) and ultrasonography (US). With MR imaging, abnormal muscles with areas of increased signal intensity were seen in every patient, which probably reflects increased water content or increased mobility of water molecules caused by inflammatory reaction and oedema in the injured and necrotic muscles. Computed tomography without intravenous contrast medium demonstrated abnormal muscles in most patients examined with this modality. The CT findings consisted of areas of focal hypodensity in muscles. With US, abnormal muscles were seen in less than half of the patients studied. The normal structure of striated muscle was focally disturbed and areas of both decreased and increased echogenicity were found. Magnetic resonance imaging had a higher sensitivity in the detection of abnormal muscles than CT or US (100%, 62% and 42%, respectively). The findings of all these modalities are non-specific, but together with the clinical and laboratory data they confirm the diagnosis of rhabdomyolysis. The information gained from imaging studies is useful in the assessment of the extent and distribution of rhabdomyolysis. The precise identification of affected muscle compartments by MR imaging is valuable when surgical fasciotomy is considered for treatment; the procedure can then be appropriately directed to the compartments with clearly abnormal muscles.
对15例急性横纹肌溶解症患者进行了低场磁共振（MR）成像评估，并将结果与计算机断层扫描（CT）和超声检查（US）的结果进行比较。在MR成像中，每位患者均可见到信号强度增加区域的异常肌肉，这可能反映了受伤和坏死肌肉中由炎症反应和水肿导致的含水量增加或水分子流动性增加。未使用静脉造影剂的计算机断层扫描在大多数接受该检查方式的患者中显示出异常肌肉。CT表现为肌肉中的局灶性低密度区域。在超声检查中，不到一半的研究患者可见异常肌肉。横纹肌的正常结构受到局灶性干扰，发现回声增强和减弱的区域。磁共振成像在检测异常肌肉方面比CT或超声具有更高的敏感性（分别为100%、62%和42%）。所有这些检查方式的结果均不具有特异性，但结合临床和实验室数据可确诊横纹肌溶解症。影像学研究获得的信息有助于评估横纹肌溶解症的范围和分布情况。当考虑手术筋膜切开术进行治疗时，通过MR成像精确识别受影响的肌肉间隔很有价值；然后可以将该手术适当地针对肌肉明显异常的间隔进行。
