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多发性肌炎大腿肌肉的并行多层加速弥散张量成像。

Simultaneous Multislice Accelerated Diffusion Tensor Imaging of Thigh Muscles in Myositis.

机构信息

1 Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing, China.

2 Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

出版信息

AJR Am J Roentgenol. 2018 Oct;211(4):861-866. doi: 10.2214/AJR.17.19318. Epub 2018 Aug 7.

Abstract

OBJECTIVE

Diffusion tensor imaging (DTI) has long been proposed as a potential tool for quantitatively evaluating muscle lesions of dermatomyositis (DM) and polymyositis (PM), but adapting DTI to thigh muscles requires minimizing acquisition time. We investigated the clinical feasibility of using SMS-EPI-DTI (simultaneous multislice [SMS] accelerated echo planar imaging [EPI] DTI) to image and analyze the anisotropic diffusion characteristics of thigh muscles in patients with DM or PM.

SUBJECTS AND METHODS

Both thighs of 20 patients (seven patients with DM and 13 patients with PM) and 10 healthy control subjects were prospectively scanned using SMSEPI-DTI. Tractographic images and DTI-derived parameters, including fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values and three eigenvalues (λ, λ, and λ), were obtained from four selected muscles (vastus medialis, vastus intermedius, adductor magnus, and semimembranosus) and were analyzed. After Bonferroni correction, p < 0.017 (0.05/3) was considered to denote statistical significance.

RESULTS

SMS-EPI-DTI allowed imaging of both thighs of patients with DM or PM and healthy control subjects within approximately 5 minutes. For each of the four measured muscles, FA values for patients with edematous muscles were lower than those for patients with unaffected muscles and healthy control subjects with normal muscles (p < 0.017 for all). The ADC and λ, λ, and λ values of edematous muscles were significantly higher than those for patients with unaffected muscles and healthy control subjects (p < 0.017 for all). Unaffected muscles of patients and healthy control subjects were similar in terms of all parameters (p > 0.017 for all).

CONCLUSION

SMS-EPI-DTI is clinically feasible for imaging thigh muscles and quantitatively evaluating edematous muscles of patients with DM or PM.

摘要

目的

弥散张量成像(DTI)长期以来一直被认为是一种定量评估皮肌炎(DM)和多发性肌炎(PM)肌肉病变的潜在工具,但适应于大腿肌肉的 DTI 需要最小化采集时间。我们研究了使用 SMS-EPI-DTI(同时多切片[SMS]加速回波平面成像[EPI]DTI)对 DM 或 PM 患者大腿肌肉的各向异性扩散特性进行成像和分析的临床可行性。

受试者和方法

前瞻性地对 20 名患者(7 名 DM 患者和 13 名 PM 患者)和 10 名健康对照者的双侧大腿进行 SMS-EPI-DTI 扫描。从四个选定的肌肉(股直肌、股中间肌、内收大肌和半膜肌)获得轨迹图像和 DTI 衍生参数,包括分数各向异性(FA)和表观扩散系数(ADC)值以及三个特征值(λ、λ 和 λ),并进行分析。经过 Bonferroni 校正,p < 0.017(0.05/3)被认为具有统计学意义。

结果

SMS-EPI-DTI 可在大约 5 分钟内对 DM 或 PM 患者和健康对照者的双侧大腿进行成像。对于每个测量的肌肉,水肿肌肉的 FA 值均低于未受影响肌肉的患者和正常肌肉的健康对照者(所有 p < 0.017)。水肿肌肉的 ADC 值和 λ、λ 和 λ 值均明显高于未受影响肌肉的患者和健康对照者(所有 p < 0.017)。患者的未受影响肌肉和健康对照者在所有参数方面均相似(所有 p > 0.017)。

结论

SMS-EPI-DTI 临床上可行,可用于成像大腿肌肉并定量评估 DM 或 PM 患者的水肿肌肉。

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