Chason D P, Fleckenstein J L, Burns D K, Rojas G
Algur H. Meadows Diagnostic Imaging Center, University of Texas, Southwestern Medical Center, Dallas 75235-8896, USA.
Skeletal Radiol. 1996 Feb;25(2):127-32. doi: 10.1007/s002560050048.
Diabetic muscle infarction (DMI) is frequently misdiagnosed clinically as abscess, neoplasm, or myositis, and is often biopsied. Clinical and radiologic findings are presented here to enable the radiologist to suggest the correct diagnosis.
Four patients with severe diabetes mellitus presenting with acute thigh pain, tenderness, and swelling were evaluated by imaging techniques and biopsy.
Edema in the affected muscles was seen in two patients with MRI studies. Femoral artery calcification and mild muscle swelling was present in one patient who underwent CT. Decreased echogenicity was seen in the involved muscle in a patient studied with ultrasound. Serum enzymes were normal or mildly elevated in three patients (not reported in one). Biopsy demonstrated necrosis and regenerative change in all cases. MRI, although nonspecific, is the best imaging technique to suggest the diagnosis of DMI in the appropriate clinical setting, thereby obviating biopsy.
糖尿病性肌肉梗死（DMI）在临床上常被误诊为脓肿、肿瘤或肌炎，且常进行活检。本文展示临床和放射学检查结果，以便放射科医生能做出正确诊断。
对4例患有严重糖尿病且出现急性大腿疼痛、压痛和肿胀的患者进行了影像学检查和活检。
2例患者经MRI检查发现患肌有水肿。1例接受CT检查的患者存在股动脉钙化和轻度肌肉肿胀。1例接受超声检查的患者受累肌肉回声降低。3例患者血清酶正常或轻度升高（1例未报告）。活检显示所有病例均有坏死和再生改变。MRI虽然不具有特异性，但在适当的临床情况下是提示DMI诊断的最佳影像学检查方法，从而避免活检。
