aInstitute of Rheumatology bDepartment of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
Curr Opin Rheumatol. 2017 Nov;29(6):623-631. doi: 10.1097/BOR.0000000000000435.
MRI is a promising imaging method commonly used to assess muscle involvement in patients with idiopathic inflammatory myopathies (IIM). MRI enables evaluation of both activity and damage and is therefore an ideal noninvasive diagnostic and monitoring tool. Despite its widespread use, there is no universally accepted method for scoring and reporting of MRI findings. The aim of this review is to provide an overview of systems used in the evaluation of MR images in patients with IIM.
A number of semi-quantitative and quantitative methods have been used to evaluate and record the severity of myopathy on MRI. These scoring systems differ in the number and type of parameters assessed and in their complexity; furthermore, they were evaluated in different patient populations, all of which make comparisons between them difficult.
There is a need to create a standardized and validated protocol for evaluation of pathological changes in muscle MRI in IIM. The most appropriate number and distribution of muscle groups as well as evaluated pathological features need to be determined. Based on this literature search, the future scoring system should include assessment of muscle oedema, fatty infiltration, muscle atrophy and possibly the presence of fascial and subcutaneous inflammation. Whether the quantitative methods provide more reliable information regarding disease activity remains unclear.
磁共振成像（MRI）是一种有前途的成像方法，常用于评估特发性炎性肌病（IIM）患者的肌肉受累情况。MRI 能够评估疾病的活动度和损伤程度，因此是一种理想的非侵入性诊断和监测工具。尽管 MRI 应用广泛，但目前仍没有一种被普遍接受的评分和报告 MRI 结果的方法。本文旨在综述用于评估 IIM 患者 MRI 图像的系统。
已经有许多半定量和定量方法用于评估和记录 MRI 上肌病的严重程度。这些评分系统在评估的参数数量和类型以及复杂性方面存在差异；此外，它们在不同的患者人群中进行了评估，这使得它们之间的比较变得困难。
有必要制定一种标准化和经过验证的方案，用于评估 IIM 中肌肉 MRI 的病理变化。需要确定最合适的肌肉群数量和分布以及评估的病理特征。基于这项文献检索，未来的评分系统应包括评估肌肉水肿、脂肪浸润、肌肉萎缩以及筋膜和皮下炎症的存在。定量方法是否能提供关于疾病活动度的更可靠信息仍不清楚。
