全身MRI在特发性炎性肌病中的应用

发布时间：2018-05-04 21:24

本文选题：肌炎 + 磁共振成像　；参考：《中国医学影像学杂志》2015年05期

【摘要】：目的探讨全身MRI检查对特发性炎性肌病(IIM)的应用价值,指导临床诊断及治疗。资料与方法回顾性分析经临床确诊的26例IIM患者,包括19例皮肌炎和7例多发性肌炎,行全身冠状位MRI及双大腿轴位MRI检查,全身MRI使用短时间反转恢复序列,轴位MRI使用T1WI和压脂相T2WI序列,并以10名健康志愿者作对照。比较各组全身MRI表现。结果对照组全身MRI显示肌肉呈均匀一致的低信号。IIM患者的全身MRI表现有肌肉炎性水肿、肌筋膜炎、皮下软组织水肿、肌萎缩和脂肪浸润。皮肌炎的肌肉炎症分布以大腿肌(18例)最常见,其次为臀肌(14例)、腰大肌(13例)、肩带肌群(11例)、小腿肌(11例)、竖棘肌(10例)和颈部肌群(9例);肌肉外表现有双肺空洞、股骨和胫骨梗死、股骨头坏死、肾上腺肿块和甲状腺结节。多发性肌炎的肌肉炎症分布以大腿肌(5例)最常见,其次为臀肌(3例)、腰大肌(3例)、肩带肌群(2例)、小腿肌(2例)、竖棘肌(1例)和颈部肌群(1例);肌肉外表现双侧股骨和胫骨梗死1例。结论全身MRI不但可以全面评价IIM患者的全身肌肉炎症活动情况,还可以发现骨梗死等并发症,在炎性肌病的诊断及指导临床合理治疗方面有重要价值。
[Abstract]:Objective to evaluate the value of systemic MRI in the diagnosis and treatment of idiopathic inflammatory myopathy. Materials and methods 26 cases of IIM, including 19 cases of dermatomyositis and 7 cases of polymyositis, were retrospectively analyzed. The systemic coronal MRI and double thigh axial MRI were performed. Axial MRI was performed using T1WI and pressure-phase T2WI sequences, and 10 healthy volunteers were used as controls. The MRI findings of all groups were compared. Results in the control group, MRI showed that there were inflammatory edema, myofascitis, subcutaneous soft tissue edema, muscle atrophy and fat infiltration. The most common muscle inflammation of dermatomyositis was in thigh muscle (n = 18), gluteus muscle (n = 14), psoas major muscle (n = 13), shoulder muscle group (n = 11), leg muscle group (n = 11), erector muscle group (n = 10) and cervical muscle group (n = 9). Infarction of femur and tibia, necrosis of femoral head, adrenal mass and thyroid nodule. Polymyositis was most common in 5 cases of thigh muscle inflammation. 3 cases of gluteal muscle, 3 cases of psoas major muscle, 2 cases of shoulder band muscle group, 2 cases of leg muscle, 1 case of erector spinus muscle) and 1 case of cervical muscle group, and 1 case of bilateral femur and tibia infarction. Conclusion systemic MRI can not only evaluate the systemic muscle inflammation in patients with IIM, but also find complications such as bone infarction, which is of great value in the diagnosis of inflammatory myopathy and the guidance of rational clinical treatment.
【作者单位】：中日友好医院放射诊断科;
【分类号】：R445.2;R593.2

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