Duchenne型肌营养不良症患儿大腿肌肉T_2 mapping成像研究  

Study on T_2 mapping in thigh muscles of patients with Duchenne muscular dystrophy

作　　者：梁颖茵[1] 操基清[1,2] 凌坚[3] 林尔坚[3] 李鸣[4] 张成[1] 

机构地区：[1]中山大学附属第一医院神经科,广州510080 [2]湖北省武汉市中心医院神经内科,邮政编码430014 [3]中山大学附属第一医院医学影像科,广州510080 [4]中山大学附属第一医院内科,广州510080

出　　处：《中国现代神经疾病杂志》2015年第6期437-441,共5页Chinese Journal of Contemporary Neurology and Neurosurgery

摘　　要：目的采用T2mapping成像测定Duchenne型肌营养不良症患儿大腿肌肉T2弛豫时间,以评价T2mapping成像在Duchenne型肌营养不良症诊断中的价值。方法共16例Duchenne型肌营养不良症患儿,均行临床严重程度分级,常规MRI(横断面T1WI、T2WI、频谱衰减反转恢复序列-T2WI脂肪抑制像)行大腿肌肉T1WI脂肪浸润分级,T2mapping成像测定T2弛豫时间。Spearman秩相关分析评价T2弛豫时间与T1WI脂肪浸润程度和临床严重程度的相关性。结果与正常对照者相比,Duchenne型肌营养不良症患儿大收肌、长收肌、股直肌、股中间肌、股内侧肌、股外侧肌、股二头肌和半膜肌共8块肌肉T2弛豫时间延长(均P<0.05),其中大收肌、股中间肌、股外侧肌、股二头肌、股直肌、长收肌和股内侧肌T2弛豫时间与T1WI脂肪浸润程度呈正相关(均P<0.05),大收肌和半膜肌T2弛豫时间与临床严重程度呈正相关(均P<0.05);T2弛豫时间与T1WI脂肪浸润程度和临床严重程度均呈正相关者仅大收肌(rs=0.867,P=0.000;rs=0.651,P=0.005)。结论 T2弛豫时间测定可用于量化和客观分析Duchenne型肌营养不良症的严重程度,大收肌是反映临床严重程度的最理想肌肉。Objective Use T2 mapping to evaluate the fatty infiltration of thigh muscles inDuchenne muscular dystrophy（DMD） patients, so as to analyze the value of T2 mapping and T2 relaxationtime in the diagnosis of DMD.MethodsSixteen DMD patients who were admitted from January 2004 toJanuary 2013 in our hospital and were diagnosed by clinical confirmation and gene detection haveparticipated into this study. These 16 male patients formed the DMD group. Six age- and sex-matchedhealthy boys were selected as control group. Clinical functional scale, thigh axial T1WI-turbo spin echo（TSE）, T2WI-TSE, spectral attenuated inversion recovery（SPAIR）-T2 WI and T2 mapping were performed inboth 2 groups. T1 WI fatty infiltration scale and T2 relaxation time were assessed in adductor magnus,gracilis, adductor longus, sartorius, rectus femoris, vastus intermedius, vastus medialis, vastus lateralis,biceps femoris, semitendinosus and semimembranosus. Spearman rank correlation was conducted to assessthe correlation between T2 relaxation time and T1 WI fatty infiltration scale or clinical functional scale.ResultsCompared with control group, the T2 relaxation time of 8 muscles（adductor magnus, adductorlongus, rectus femoris, vastus intermedius, vastus medialis, vastus lateralis, biceps femoris andsemimembranosus） in DMD group were prolonged（P 〈0.05, for all）. The longest average T2 relaxation timewas found in adductor magnus. The T2 relaxation time of adductor magnus, vastus intermedius, vastuslateralis, biceps femoris, rectus femoris, adductor longus and vastus medialis was positively correlated withT1 WI fatty infiltration scale（P 〈0.05, for all）, and the T2 relaxation time of adductor magnus andsemimembranosus was positively correlated with clinical funetional scale（P 〈0.05, for all）. A positive correlation was found in adductor magnus between T2 relaxation time and both T1 WI fatty infiltration scale（rs= 0.867, P = 0.000） and clinical functional scale（rs= 0.651, P = 0.005）.ConclusionsT2 relaxation

关 键 词：肌营养不良 杜氏 腿 磁共振成像 

分 类 号：R746.2[医药卫生—神经病学与精神病学]