Zhang F, Xu J, Wang X X, Cheng Y Q, Chen W
Department of Rheumatology and Immunology, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China.
Yunnan Provincial Clinical Medicine Research Center of Rheumatism in Traditional Chinese Medicine,Yunnan Provincial Hospital of Traditional Chinese Medicine,Kunming 650021, China.
Zhonghua Nei Ke Za Zhi. 2024 Apr 1;63(4):401-405. doi: 10.3760/cma.j.cn112138-20231014-00211.
This study aimed to explore the value of magnetic resonance imaging (MRI) T mapping in the assessment of dermatomyositis (DM) and polymyositis (PM). Thirty-three confirmed cases (myosin group) and eight healthy volunteers (healthy control group) at the Department of Rheumatology and Immunology, the First Affiliated Hospital of Kunming Medical University, from October 2016 to December 2017, were collected and analyzed. Multiple parameters of the myosin group were quantified, including creatine kinase (CK), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), complement C3, and complement C4. Disease status was evaluated using a panel of tools: myositis disease activity assessment tool-muscle (MDAAT-muscle), myositis disease activity assessment tool-whole (MDAAT-all), health assessment questionnaire (HAQ), medical outcomes study health survey short form-36 item (SF-36), hand muscle strength test (MMT-8) score, and MRI T mapping of muscle (22 muscles in the pelvis and thighs) T values. The results showed that in the myositis group, the measurements for CK, ESR, CRP, complement C3, and complement C4 were 457.2 (165.6, 1 229.2) IU/L, 20 (10, 42) mm/1h, 3.25 (2.38, 10.07) mg/L, 0.90 (0.83, 1.06) g/L, and 0.18 (0.14, 0.23) g/L, respectively. The scores for MMT-8, MDAAT-muscle, MDAAT-all, HAQ, and SF-36 were 57.12±16.23, 5.34 (4.00, 6.00), 34.63±12.62, 1.55 (0.66, 2.59), and 44.66±7.98, respectively. T values were significantly higher in all 22 muscles of the pelvis and thighs of patients with DM or PM compared with the healthy controls [(54.99±11.60)ms vs. (36.62±1.66)ms, 0.001], with the most severe lesions in the satrorius, iliopsoas, piriformis, gluteus minimus, and gluteus medius muscles. The total muscle T value in the myositis group was positively correlated with CK, MDAAT-muscle, MDAAT-all, and HAQ (0.461, 0.506, 0.347, and 0.510, respectively, all 0.05). There was a negative correlation between complement C4, SF-36, and MMT-8 scores (-0.424, -0.549, and -0.686, respectively, all 0.05). Collectively, the findings from this study suggest that MRI T mapping can objectively reflect the disease status of DM and PM.
本研究旨在探讨磁共振成像(MRI)T 图谱在皮肌炎(DM)和多发性肌炎(PM)评估中的价值。收集并分析了 2016 年 10 月至 2017 年 12 月期间昆明医科大学第一附属医院风湿免疫科的 33 例确诊病例(肌炎组)和 8 名健康志愿者(健康对照组)。对肌炎组的多个参数进行了量化,包括肌酸激酶(CK)、红细胞沉降率(ESR)、C 反应蛋白(CRP)、补体 C3 和补体 C4。使用一组工具评估疾病状态:肌炎疾病活动评估工具-肌肉(MDAAT-肌肉)、肌炎疾病活动评估工具-整体(MDAAT-整体)、健康评估问卷(HAQ)、医学结局研究健康调查简表-36 项(SF-36)、手部肌肉力量测试(MMT-8)评分以及肌肉的 MRI T 图谱(骨盆和大腿的 22 块肌肉)T 值。结果显示,肌炎组中 CK、ESR、CRP、补体 C3 和补体 C4 的测量值分别为 457.2(165.6,1229.2)IU/L、20(10,42)mm/1h、3.25(2.38,10.07)mg/L、0.90(0.83,1.06)g/L 和 0.18(0.14,0.23)g/L。MMT-8、MDAAT-肌肉、MDAAT-整体、HAQ 和 SF-36 的评分分别为 57.12±16.23、5.34(4.00,6.00)、34.63±12.62、1.55(0.66,2.59)和 44.66±7.98。与健康对照组相比,DM 或 PM 患者骨盆和大腿的所有 22 块肌肉的 T 值均显著更高[(54.99±11.60)ms 对(36.62±1.66)ms,P<0.001],其中缝匠肌、髂腰肌、梨状肌、臀小肌和臀中肌的病变最为严重。肌炎组的总肌肉 T 值与 CK、MDAAT-肌肉、MDAAT-整体和 HAQ 呈正相关(分别为 0.461、0.506、0.347 和 0.510,均 P<0.05)。补体 C4、SF-36 和 MMT-8 评分之间呈负相关(分别为-0.424、-0.549 和-0.686,均 P<0.05)。总体而言,本研究结果表明 MRI T 图谱可客观反映 DM 和 PM 的疾病状态。