摘要
Abstract
Objective To evaluate and compare the diagnostic value of magnetic resonance imaging T2 mapping and T1WI fatty score system in patients with Duchenne muscular dystrophy (DMD). Methods Twenty-seven patients with pathologically or gene proved DMD were enrolled in this study from November 2012 to June 2013.All the patients were male with an average age of 8.53±6.25 years,and the average course of disease was 4.17±3.79 years.Twelve healthy volunteers were recruited as the control group,including 7 male and 5 female,with an average age of 25.67 ±1.23 years.All subjects were underwent MRI examination of the lower extremities and MRI performance were evalulated.The T1 fat scoring system was used to classify the fat infiltration,and the T2mapping imaging was used to deteminre the T2value.The difference in T2 value was tested by independent sample t test between the patient and the control groups.Pearson correlation analysis was used to investigate the correlation between the T2values and T1fat score,and the correlation between two group with age,course of disease,and creatine kinase level.Spearman rank correlation analysis was used to explore the correlation between the T2value and the T1fat score with the clinical grade of the case group.Results In 22 patients,MRI showed a different degree of fatty infiltration in the affected muscles and the T1WI showed high signal.No abnormal MRI features were observed in five patients.The degree of involvement of the muscles varied.The T1fat score and T2value have similar distribution,both showing the most frequently involved muscle was the adductor magnus (T2value=243 ms,T1fat score=2.8),followed by the gluteus maximus(T2value=243 ms,T1fat score=2.7),vastus lateralis(T2value=225 ms,T1 fat score=1.9).The least affected muscle was the gracilis(T2value=171 ms,T1fat score=0.3),the sartorius muscle(T2value=170 ms,T1fat score=0.6),and the adductor longus (T2value=175 ms,T1fat score=0.4).The average T2value (211.9±65.2 ms)of the patients was significantly higher than that of the control group (141.6±16.7 ms) (t=5.228,P<0.001).The T2 value of the patients with normal MR features(158.1±15.4 ms)was mildly higher than that of control group(141.6±16.7 ms),but the difference was not statistically significant (t=1.89,P=0.078).The T2value was positively correlated with the T1 fat score,course of disease and clinical grade (all P<0.05),while was negatively correlated with age and creatine kinase value (all P>0.05).The T1fat score was positively correlated with age,course of disease,and clinical grade (all P<0.05),while was negative correlated with creatine kinase value (P>0.05).Conclusions T2mapping and T1fat scoring system both can well evaluate the distribution of muscle involvement and the severity of the disease in patients with Duchenne muscular dystrophy. The T2value is positively correlated with the T1fat score of the lower limb muscles in patients with Duchenne muscular dystrophy,while the T2value is more objective than T1fat score.关键词
Duchenne型肌营养不良/儿童/磁共振成像/T2mapping成像Key words
Duchenne muscular dystrophy/Children/Magnetic resonance imaging/T2mapping分类
医药卫生
