Ortolan Paolo, Zanato Riccardo, Coran Alessandro, Beltrame Valeria, Stramare Roberto
Radiology Unit, Department of Medicine, University of Padova , Italy.
Eur J Transl Myol. 2015 Mar 11;25(2):5014. doi: 10.4081/ejtm.2015.5014.
Great technologic and clinical progress have been made in the last two decades in identifying genetic defects of several neuromuscular diseases, as Spinal Muscular Atrophy, genetic muscular dystrophies and other genetic myopathies. The diagnosis is usually challenging, due to great variability in genetic abnormalities and clinical phenotypes and the poor specificity of complementary analyses, i.e., serum creatine kinase (CK) and electrophysiology. Muscle biopsy represents the gold standard for the diagnosis of genetic neuromuscular diseases, but clinical imaging of muscle tissue is an important diagnostic tool to identify and quantifyies muscle damage. Radiologic imaging is, indeed, increasingly used as a diagnostic tool to describe patterns and the extent of muscle involvement, thanks to modern techniques that enable to definethe definition of degrees of muscle atrophy and changes in connective tissue. They usually grade the severity of the disease process with greater accuracy than clinical scores. Clinical imaging is more than complementary to perform muscle biopsy, especially as ultrasound scans are often mandatory to identify the muscle to be biopsied. We will here detail and provideWe will herein provide detailed examples of the radiologic methods that can be used in genetic and acquired neuromuscular disorders, stressing pros and cons.
Muscle Imaging, MRI, CT, genetic muscle disorders, myopathies, dystrophies.
在过去二十年中,在识别几种神经肌肉疾病(如脊髓性肌萎缩症、遗传性肌营养不良症和其他遗传性肌病)的基因缺陷方面取得了巨大的技术和临床进展。由于基因异常和临床表型的高度变异性以及补充分析(即血清肌酸激酶(CK)和电生理学)的特异性较差,诊断通常具有挑战性。肌肉活检是诊断遗传性神经肌肉疾病的金标准,但肌肉组织的临床成像也是识别和量化肌肉损伤的重要诊断工具。事实上,由于现代技术能够定义肌肉萎缩程度和结缔组织变化,放射学成像越来越多地被用作描述肌肉受累模式和程度的诊断工具。它们通常比临床评分更准确地对疾病进程的严重程度进行分级。临床成像对于进行肌肉活检而言不仅仅是一种补充,尤其是因为超声扫描通常是识别要进行活检的肌肉所必需的。我们将在此详细介绍并提供可用于遗传性和获得性神经肌肉疾病的放射学方法的详细示例,强调其优缺点。
肌肉成像、磁共振成像、计算机断层扫描、遗传性肌肉疾病、肌病、肌营养不良症