抗信号识别颗粒抗体肌病与多发性肌炎的磁共振成像对比  

Comparison of muscle magnetic resonance imaging in myopathy with anti-signal recognition particle antibodies and polymyositis

作　　者：刘琳琳[1] 杜婧[2] 郝洪军[1] 高枫[1] 吕鹤[1] 张巍[1] 肖江喜[2] 袁云[1] 

机构地区：[1]北京大学第一医院神经内科,100034 [2]北京大学第一医院放射科,100034

出　　处：《中华神经科杂志》2014年第4期232-235,共4页Chinese Journal of Neurology

基　　金：科技部＂十二五＂重大专项课题（2011ZX09307-001-07）

摘　　要：目的 对比抗信号识别颗粒抗体肌病（MASRP）和多发性肌炎（PM）患者大腿骨骼肌MRI改变的差异.方法 对9例MASRP和21例PM患者[平均年龄分别为（37.2 ±13.1）岁和（43.8 ±20.6）岁]行双侧大腿骨骼肌MRI检查,在T1WI和短时间反转恢复序列（STIR）上分别观察肌肉脂肪化及水肿,计算每块肌肉脂肪化及水肿出现率和评分,比较两种炎性肌肉病的差异.结果 9例MASRP患者均出现了肌肉水肿和脂肪化改变,平均评分各为（1.85±0.37）分和（1.30±0.28）分,两者平均分之间的差异无统计学意义.21例PM患者中有18例出现肌肉水肿,14例出现脂肪化,平均评分各为（1.67±0.43）分和（0.52±0.23）分,前者高于后者,差异有统计学意义（t=4.565,P =0.000）.MASRP患者脂肪化出现比例高于PM,差异有统计学意义（x2=3.913,P=0.048）,其脂肪化平均评分也高于PM,差异有统计学意义（t=3.060,P=0.005）.两种炎性肌肉病的水肿出现比例和评分差异无统计学意义.结论 MASRP患者的骨骼肌更易出现脂肪化.PM患者骨骼肌水肿比脂肪化明显,但其程度和MASRP无差异.Objective To compare the difference of magnetic resonance imaging （MRI） changes of the thigh muscles in myopathy with anti-signal recognition particle antibodies （MASRP） and polymyositis （PM）.Methods We collected 9 patients with MASRP and 21 patients with PM.The mean ages for them were （37.2 ± 13.1） and （43.8 ±20.6） years old respectively.Muscle MRI was performed at thigh level.T1 WI was to observe fatty infiltration and short time inversion recovery imaging was to observe muscle edema.The frequency and score of the fatty infiltration and edema of muscles were calculated and compared between two types of myositis.Results In MASRP,muscle edema and fatty infiltration were found in all 9 patients.Scores of two changes were 1.85 ± 0.37 and 1.30 ± 0.28 respectively,and there were no significant differences between them.In PM,the frequencies of muscle edema and fatty infiltration were 18/21 and 14/21.Scores of two changes were 1.67 ± 0.43 and 0.52 ± 0.23.The score of the muscle edema was higher than the fatty infiltration （t =4.565,P =0.000）.MASRP was higher than PM in frequency （x2 =3.913,P=0.048） and score （t =3.060,P =0.005） of the fatty infiltration.There were no differences in the frequency and score of the edema between two types of myositis.Conclusions The fatty infiltration in muscles occurs more predominantly in MASRP.The muscle edema is more obvious than the fatty infiltration in PM,but has the same severity of MASRP.

关 键 词：肌疾病 多发性肌炎 肌 骨骼 磁共振成像 

分 类 号：R746[医药卫生—神经病学与精神病学]