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成人和儿童皮肌炎的影像学检查

Imaging in dermatomyositis in adults and children.

作者信息

Sudoł-Szopińska Iwona, Jacques Thibaut, Gietka Piotr, Cotten Anne

机构信息

Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation , Warsaw , Poland.

Department of Musculoskeletal Radiology, Lille University Hospital , Lille , France.

出版信息

J Ultrason. 2020;20(80):e36-e42. doi: 10.15557/JoU.2020.0007. Epub 2020 Mar 31.

Abstract

Dermatomyositis is a rare autoimmune disorder in which an abnormal immune reaction against vascular endothelial antigens and endomysium leads to obstructive inflammatory changes of blood vessels within muscles, skin and other tissues. The disease is characterized by involvement of muscles, and less frequently of other systems, including the gastrointestinal tract, heart and lungs. Dermatomyositis may be diagnosed based on a detailed patient history, through clinical examination, detection of characteristic physical findings and certain specialized tests. Additional imaging studies may be performed to aid in the diagnosis. These include magnetic resonance imaging and ultrasound of the affected muscles. Magnetic resonance imaging is the modality of choice in the diagnostic work-up and monitoring of dermatomyositis affecting muscles, fasciae, and the subcutis. It may recognize acute inflammatory edematous changes in the affected muscles as well fatty replacement and atrophy. The role of ultrasound to diagnose and follow up muscle echogenicity, vascularity, elasticity and volume during treatment has increased over the last years in both adults and children. Ultrasound is used to discriminate between high and low disease activity, may show features of subclinical disease and may be used to confirm remission. Dermatomyositis is a rare autoimmune disorder in which an abnormal immune reaction against vascular endothelial antigens and endomysium leads to obstructive inflammatory changes of blood vessels within muscles, skin and other tissues. The disease is characterized by involvement of muscles, and less frequently of other systems, including the gastrointestinal tract, heart and lungs. Dermatomyositis may be diagnosed based on a detailed patient history, through clinical examination, detection of characteristic physical findings and certain specialized tests. Additional imaging studies may be performed to aid in the diagnosis. These include magnetic resonance imaging and ultrasound of the affected muscles. Magnetic resonance imaging is the modality of choice in the diagnostic work-up and monitoring of dermatomyositis affecting muscles, fasciae, and the subcutis. It may recognize acute inflammatory edematous changes in the affected muscles as well fatty replacement and atrophy. The role of ultrasound to diagnose and follow up muscle echogenicity, vascularity, elasticity and volume during treatment has increased over the last years in both adults and children. Ultrasound is used to discriminate between high and low disease activity, may show features of subclinical disease and may be used to confirm remission.

摘要

皮肌炎是一种罕见的自身免疫性疾病,针对血管内皮抗原和肌内膜的异常免疫反应会导致肌肉、皮肤及其他组织内血管的阻塞性炎症改变。该病的特征是肌肉受累,其他系统受累相对较少,包括胃肠道、心脏和肺部。皮肌炎可根据详细的患者病史、通过临床检查、发现特征性体征及某些专门检查来诊断。可进行额外的影像学检查以辅助诊断。这些检查包括对受累肌肉进行磁共振成像和超声检查。磁共振成像在皮肌炎累及肌肉、筋膜和皮下组织的诊断评估及监测中是首选方式。它可以识别受累肌肉中的急性炎症性水肿改变以及脂肪替代和萎缩。在过去几年中,超声在诊断及随访治疗期间肌肉的回声性、血管性、弹性和体积方面的作用在成人和儿童中都有所增加。超声用于区分疾病活动度的高低,可能显示亚临床疾病的特征,还可用于确认缓解情况。皮肌炎是一种罕见的自身免疫性疾病,针对血管内皮抗原和肌内膜的异常免疫反应会导致肌肉、皮肤及其他组织内血管的阻塞性炎症改变。该病的特征是肌肉受累,其他系统受累相对较少,包括胃肠道、心脏和肺部。皮肌炎可根据详细的患者病史、通过临床检查、发现特征性体征及某些专门检查来诊断。可进行额外的影像学检查以辅助诊断。这些检查包括对受累肌肉进行磁共振成像和超声检查。磁共振成像在皮肌炎累及肌肉、筋膜和皮下组织的诊断评估及监测中是首选方式。它可以识别受累肌肉中的急性炎症性水肿改变以及脂肪替代和萎缩。在过去几年中,超声在诊断及随访治疗期间肌肉的回声性、血管性、弹性和体积方面的作用在成人和儿童中都有所增加。超声用于区分疾病活动度的高低,可能显示亚临床疾病的特征,还可用于确认缓解情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54bd/7266069/a6db9aa03d77/jou-20-80-e36-g001.jpg

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