MRI对Duchenne肌营养不良的诊断价值  

The diagnostic value of MRI in Duchenne muscular dystrophy

作　　者：王霞[1] 赵初青[1] 王文涛[1] 宫少勇[1] 裘晟[1] 杨小军[1] 姚晓群[1] 杨广夫[1] 

机构地区：[1]西安交通大学附属西安高新医院影像科,陕西西安710075

出　　处：《实用放射学杂志》2016年第9期1414-1417,1421,共5页Journal of Practical Radiology

基　　金：国家临床重点专科建设项目（2010305）.

摘　　要：目的 探讨MRI对Duchenne肌营养不良的诊断价值。方法 收集确诊为Duchenne肌营养不良的男性患儿64例，行盆底（62例）、大腿（62例）、小腿（59例）（共692组肌群）MRI检查，轴位T1WI、T2WI、SPIR及冠位T2WI扫描。由2名高年资医生独立重点观察：（1）肢体肥大或萎缩；（2）病变肌肉对称性；（3）病变肌肉累及分布；（4）MRI信号特点（脂肪浸润或炎性水肿）；（5）9例治疗后复查改变。结果 （1）肢体肥大者17例（26.56%），萎缩者12例（18.75%）。（2）4例（6.25%）两侧肌群累及不对称，余肌群受累基本对称。（3）①盆肌：臀大肌受累87.10%，盆底收肌67.74%（χ^2=6.643，P=0.010）。②大腿：股四头肌82.26%，股二头肌75.81%，半腱肌62.90%，半膜肌80.65%，缝匠肌69.23%，股薄肌22.58%（χ^2=67.075，P=0.000）。③小腿：胫骨前肌23.73%，胫骨后肌32.20%，腓肠肌81.36%，比目鱼肌57.63%（χ^2=48.218，P=0.000）。上述肌群均表现有脂肪浸润共352组（352/692，50.87%）。其中，发现炎性水肿者203组（203/352,57.67%）。≥50%伴有炎性水肿肌群见于臀大肌、股四头肌、胫骨前肌、胫骨后肌和比目鱼肌。（4）9例患者经2～5年治疗复查，MRI变化不一致。结论 MRI对Duchenne肌营养不良的检查诊断有重要作用。下肢肌肉改变应重点观察大肌群如臀大肌、股四头肌、半膜肌及腓肠肌等。Objective To explore the diagnostic value of MRI in Duchenne muscular dystrophy. Methads MRI data of 64 male children with Duchenne muscular dystrophy were collected in our hospital. Philips 1.5T dual gradient systerm with 8 array coil was used to study the pelvis （ n= 62 ）, thigh （ n= 62 ） and shank （ n= 59 ） （ 692 muscles in total ） , and the transverse T1 WI, T2 Wl and SPIR sequences and coronal T2 WI were performed. Two radiologists independently reviewed the following main MRI changes ： （ 1 ） Muscular hypertrophy or atrophy; （ 2 ） Symmetry of involved muscles ; （ 3） Distribution of involved muscles; （ 4 ） Signal characteristics （ fatty infiltration or inflammatory edema） ; （5） Changes of follow-up after treatment. Results （ 1 ） There were 17 cases of muscular hypertrophy （26.56%） and 12 cases of muscular atrophy （18.75%）. （2） Asymmetry changes of bilateral muscles were found in 4 cases （6.25%）. （3） Distribution of involved muscles was showed as following： ① for pelvic muscles, the gluteus maximus was found in 87.10%, the adductors in 67.74% （χ^2=6.643, P=0.010）. ② for thigh muscles, the quadriceps femoris was found in 82.26%, biceps femoris in 75.81%, semitendious in 62.90%, semimemhranous in 80.65% ,sartorius in 69.23%/00, gracilius in 22.58%, （χ^2 =67. 075. 643,P=0. 000）. ③ for shank muscles, the tibialis anterior was found in 23.73%/00, tibialis posterior 32.20%, gastrocnemius in 81.36%, soleus in 57.63%, （χ^2=48.218,P=0.0001. Fatty infiltration was showed in mentioned above muscles （352 muscles, 352/692,50.87% ） , in which inflammatory edema was found in 203 muscles （203/352,57.67% ）. That the inflammatory edema muscles was 950% involved muscles was showed in the gluteus maximus, quadriceps femoris, tibialis anterior, tibialis posterior and soleus. （4） There were various changes for follow up check in 9 cases. Conclusion MRI play an imporlant rule in diagnosis of Duchenne muscular dystrophy. In the analysis

关 键 词：DUCHENNE肌营养不良 磁共振成像 

分 类 号：R685[医药卫生—骨科学] R445.2[医药卫生—外科学]