扩散峰度成像对皮肌炎/多发性肌炎的诊断价值  

Value of Diffusion Kurtosis Imaging in the Diagnosis of Dermatomyositis/Polymyositis

作　　者：吴小青[1] 贾岩龙 邓晶[2] 田红岸 王升忠 朱华浩 镇方寿 余开湖[2] WU Xiaoqing;JIA Yanlong;DENG jing(Department of Medical Imaging,Hubei University of Medicine,Shiyan, Hubei Province 442000,P.R.China)

机构地区：[1]湖北医药学院医学影像学系,十堰442000 [2]湖北科技学院附属第一医院,咸宁市中心医院放射科,咸宁437000 [3]咸宁麻塘风湿病医院放射科,咸宁437000

出　　处：《临床放射学杂志》2018年第12期2076-2080,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金面上项目(编号:81571644)

摘　　要：目的探究扩散峰度成像(DKI)在皮肌炎(DM)/多发性肌炎(PM)的影像表现及特征性参数,并探讨在临床诊断及疗效评估中的价值。方法搜集2016年1月至2017年10月本院及咸宁麻塘风湿病医院DM/PM患者12例,纳入标准符合1975年Bohan等提出的诊断标准,另选择12名健康志愿者为对照组,所有受试者均行双侧大腿轴位T1WI、T2WI、DKI序列扫描,经GE 3.0 T后处理工作站分析和测量得到DKI参数值:平均扩散峰度(MK)、平均扩散系数(MD)。采用单因素方差分析比较组间参数差异。结果 DM/PM患者病变肌肉及正常肌肉MD值分别是(2.102±0.357)×10^-3mm^2/s、(2.221±0.538)×10-3^mm^2/s,差异有统计学意义(P<0.05)。两组MK值分别是(0.507±0.100)、(0.411±0.052),差异有统计学意义(P<0.05)。其中,DM/PM组MD值低于正常肌肉,MK高于正常肌肉,差异有统计学意义(P<0.05)。结论 DKI可用于肌肉疾病的影像诊断,尤其对肌肉炎性水肿更敏感,可定量评估肌肉水分子真实扩散情况,DKI对DM/PM诊断具有重要意义,且MK、MD值可能对DM/PM的早期诊断具有特征性。Objective To explore the diffuse kurtosis imaging(DKI)in dermatomyositis/polymyositis in the imaging diagnosis and characteristic parameters,to study the value of the clinical diagnosis and evaluation of curative effect.Methods We reviewed the images of 12 patients with the diagnostic criteria of DM/PM proposed by Bohan and Peter in 1975,who were treated in our hospital and rheumatism hospital of matang xianning between 2016 and 2017.And 12 healthy volunteers(control group)were enrolled in this study.Axial views with T1WI、T2WI and DKI sequences were performed on bilateral thighs of all subjects.The DKI parameters included MK(mean kurtosis)、MD(mean diffusivity)were measured after post-processing workstation of GE 3.0T.One-way analysis of variance was used for statistical analyses.Results The MD of diseased muscles in the DM/PM group and normal muscle in control group was(2.102±0.3570)×10-3mm2/s、(2.221±0.538)×10^-3mm^2/s respectively,with statistic difference(P<0.05).The MK value of the two groups mentioned above was(0.507±0.100)、(0.411±0.052)respectively,with statistic difference(P<0.05).The MD value of diseased muscles in DM/PM group was lower than that of normal group with statistic difference(P<0.05).The MK value of diseased muscles in DM/PM group was higher than that of normal group with statistic difference(P<0.05).Conclusion DKI technique could be used to diagnose myopathy,particularly,it is more sensitive to edematous muscle,to quantitatively evaluate the H20 diffusion of muscles,DKI provided important diagnostic information for DM/PM,maybe MD/MK could have characteristic diagnostic value for patients with DM/PM in early diagnosis.

关 键 词：皮肌炎 多发性肌炎 磁共振成像 扩散峰度成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R593.26[医药卫生—诊断学]