MRI诊断多发性肌炎及皮肌炎的临床价值  

Clinical Values of MRI in the Diagnosis of Polymyositis and Dermatomyositis

作　　者：王瑞[1] 王菲菲[1] 杨俊亚[1] 曹鸿玮[1] 郑晓红[1] WANG Rui;WANG Fei-fei;YANG Jun-ya(Department of Dermatology&STD,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第五附属医院皮肤性病科,河南郑州450052

出　　处：《中国CT和MRI杂志》2018年第4期146-148,共3页Chinese Journal of CT and MRI

摘　　要：目的观察核磁共振(MRI)诊断多发性肌炎(polymyositis,PM)及皮肌炎(dermatomyositis,DM)的临床价值。方法选取拟诊为PM/DM的76例肌病患者为研究对象,均行MRI、肌电图(electromyography,EMG)、肌肉活检检查,测定血清肌酸磷酸激酶(creatinine phosphkinaes,CK)水平,观察皮肤损害情况;以EMG、肌肉活检、CK、皮肤损害情况联合检查结果为依据,评估MRI诊断PM/DM的灵敏度、特异度、准确度、阳性及阴性预测值,观察PM/DM患者的MRI表现。结果 76例受试者中,综合诊断呈阳性者58例,呈阴性者18例;MRI诊断PM/DM的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为81.03%、94.44%、84.21%、97.92%和60.71%。肌肉炎性水肿47例(61.84%)、皮下结缔组织水肿20例(26.32%)、肌筋膜炎32例(42.11%)、脂肪浸润肌肉萎缩5例(6.58%)。结论 MRI诊断PM/DM具有较高的灵敏度、特异度、准确度,图像特点明显,且为无创检查,重复性好,对及早检出病变部位、指导后续病理活检有一定帮助。Objective To observe the clinical values of magnetic resonance imaging(MRI)in the diagnosis of polymyositis(PM)and dermatomyositis(DM).Methods 76 cases of myopathy patients suspected PM/DM were selected for the study and were given the MRI,electromyography(EMG)and muscle biopsy.Serum creatine phosphokinase(CK)level was measured,and the skin damages were observed.The sensitivity,specificity,accuracy,positive and negative predictive values of MRI in the diagnosis PM/DM were evaluated based on the combined results of EMG,muscle biopsy,CK and skin damages,and the MRI findings of PM/DM patients were observed.Results Among the 76 cases of subjects,58 cases were positive and 18 cases were negative by comprehensive diagnosis.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of MRI in the diagnosis of PM/DM were 81.03%,94.44%,84.21%,97.92%and 60.71%respectively.There were 47 cases(61.84%)of muscle inflammatory edema,20 cases(26.32%)of subcutaneous connective tissue edema,32 cases(42.11%)of myofascitis and 5 cases(6.58%)of fat infiltration atrophy.Conclusion The MRI diagnosis for PM/DM has high sensitivity,specificity,accuracy and obvious image features,and it is noninvasive examination with good repeatability,and it has some help in the early detection of lesion sites and the guidance of follow-up pathological biopsy.

关 键 词：MRI 多发性肌炎 皮肌炎 

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