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目的探讨MR T2-mapping在多发性肌炎(PM)、皮肌炎(DM)诊断和疗效评估中的价值。方法对37例临床拟诊PM、DM患者行大腿部肌肉常规MRI扫描及T2-mapping扫描,由两位不知道患者信息的放射科医师分别独立测量肌肉T2值。依据最终临床诊断,剔除1例无肌病型DM患者。将36例患者分为三组,即A组:炎症活动期(16例);B组:稳定期(10例);C组:对照组(10例)。比较不同病例组之间的肌肉T2值,并采用统计学方法检验。结果 STIR序列显示:A组患者主要表现为双大腿肌肉弥漫片状高信号,B组及C组患者未见明确高信号;A、B、C组患者肌肉T2值分别为(75.0±31.9)ms、(41.7±3.3)ms、(40.9±4.3)ms;A组患者肌肉T2值明显高于B组和C组,差异有统计学意义(PAB=0.002;PAC=0.001);B组和C组患者肌肉T2值差异无统计学意义(PBC=0.954)。A组中3例患者治疗后进行了MRI复查,3例患者治疗后血清肌酶及肌肉T2值均有下降。结论在常规MRI扫描判断肌肉有无炎性改变的基础上,应用T2-mapping序列可对炎性病变程度进行有效量化,对炎性肌病的诊断、疗效评估和指导临床合理治疗方面有很高的应用价值。
Objective To investigate the value of MR T2-mapping in the diagnosis and evaluation of polymyositis (PM) and dermatomyositis (DM). Methods Thirty-seven patients with clinically suspected PM and DM underwent routine MRI and T2-mapping scans of the thigh muscles. Two T2 radiologists, who did not know the patient’s information, independently measured the T2 value. Based on the final clinical diagnosis, 1 patient without myopathy was excluded. Thirty-six patients were divided into three groups: group A: inflammatory stage (16 cases); group B: stable stage (10 cases); group C: control group (10 cases). The T2 values of muscle between different groups were compared and tested by statistical methods. Results The results of STIR showed that in group A, there were mainly diffuse flaky signals in both thigh muscles and no obvious hyperintensities in groups B and C. The T2 values of muscles in groups A, B and C were (75.0 ± 31.9) ms , (41.7 ± 3.3) ms and (40.9 ± 4.3) ms, respectively. The muscle T2 value of group A was significantly higher than that of group B and C (PAB = 0.002; PAC = 0.001) There was no significant difference in T2 values between patients (PBC = 0.954). Three patients in group A underwent MRI review after treatment, and all three patients had decreased serum muscle enzymes and muscle T2 values after treatment. Conclusion In the conventional MRI scan to determine the presence or absence of muscle inflammatory changes, based on the use of T2-mapping sequence can effectively quantify the degree of inflammatory lesions, the diagnosis of inflammatory myopathy, evaluation of the effectiveness and guidance of clinical rational treatment of high The application value.