Helmy Hanan, Aboumousa Ahmed, Abdelmagied Asmaa, Alsayyad Aya, Nasr Sandra Ahmed
1Neurology, Cairo University, Cairo, Egypt.
2Radio-Diagnosis, Cairo University, Cairo, Egypt.
Egypt J Neurol Psychiatr Neurosurg. 2018;54(1):29. doi: 10.1186/s41983-018-0039-6. Epub 2018 Nov 1.
Selective involvement of certain muscles is an indicator for muscle diseases and helps to direct the diagnosis, but in some cases, it cannot be detected clinically; hence, the roles of muscle MRI and ultrasound are to detect this selectivity and facilitate the diagnosis.
The possibility of using muscle ultrasound as a screening tool when muscle diseases are suspected and as an alternative to MRI.
This cross-sectional descriptive study included 38 patients presented with clinical manifestations suggestive of muscle diseases. The patients were selected over a period of 1 year. All patients were subjected to thorough clinical assessment and muscle ultrasound of the thigh and leg for all patients, while 15 were subjected to MRI. Clinical and radiological assessments were performed separately, followed by both clinical and radiological findings to assess the power of combining the clinical and radiological assessments for the diagnosis of muscle diseases.
The clinical assessment reached a main provisional probable diagnosis in 53% cases, and radiological assessment blind to clinical data suggested diagnosis in 18 of the total cases, while the combination of both ultrasound and MRI could suggest diagnosis in 87% of the cases. The concordance ratio of ultrasound to MRI ranged between 78 and 100%.
The combination of clinical and radiological assessments of muscle diseases can suggest a main provisional probable diagnosis, especially when genetic diagnosis is not accessible, or to direct the genetic testing when it is available. Ultrasound can be used as a routine tool in screening and follow-up of muscle diseases.
特定肌肉的选择性受累是肌肉疾病的一个指标,有助于指导诊断,但在某些情况下,临床无法检测到;因此,肌肉磁共振成像(MRI)和超声的作用是检测这种选择性并促进诊断。
探讨在怀疑肌肉疾病时将肌肉超声作为筛查工具以及作为MRI替代方法的可能性。
这项横断面描述性研究纳入了38例有提示肌肉疾病临床表现的患者。这些患者在1年的时间里被选取。所有患者均接受了全面的临床评估,所有患者均对大腿和小腿进行了肌肉超声检查,其中15例还接受了MRI检查。临床和影像学评估分别进行,然后综合临床和影像学检查结果,以评估联合临床和影像学评估对肌肉疾病诊断的效能。
临床评估在53%的病例中得出主要的初步可能诊断,对临床数据不知情的影像学评估在所有病例中的18例中提示了诊断,而超声和MRI联合检查能在87%的病例中提示诊断。超声与MRI的一致性比率在78%至100%之间。
肌肉疾病的临床和影像学评估相结合可得出主要的初步可能诊断,尤其是在无法进行基因诊断时,或在有基因检测时指导基因检测。超声可作为肌肉疾病筛查和随访的常规工具。