MR定量功能成像对杜氏肌营养不良与贝氏肌营养不良的鉴别诊断  

MR Quantitative Functional Imaging in the Differential Diagnosis of Duchenne Muscular Dystrophy and Becker Muscular Dystrophy

作　　者：卜姗姗 肖江喜[1] 朱颖[1] 殷亮[1] 关冲霄 王朝霞[2] BU Shanshan;XIAO Jiangxi;ZHU Ying;YIN Liang;GUAN Chongxiao;WANG Zhaoxia(Department of Radiology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院医学影像科,北京100034 [2]北京大学第一医院神经内科,北京100034

出　　处：《中国医学影像学杂志》2021年第2期163-167,共5页Chinese Journal of Medical Imaging

摘　　要：目的常规MRI序列无法精确反映杜氏肌营养不良(DMD)和贝氏肌营养不良(BMD)的差异,本研究拟探讨MR功能序列对两者的鉴别诊断价值。资料与方法前瞻性纳入经临床活检和(或)基因检测确诊为DMD患者79例、BMD患者35例,同期纳入健康志愿者15例(对照组)。对所有研究对象行IDEAL-IQ及T2 mapping序列检查。分别测量臀部及大腿肌肉共12块的脂肪分数(FF)值及T2值;比较3组各参数的差异,分析DMD组和BMD组各肌肉FF值与T2值之间的相关性,利用受试者工作特征(ROC)曲线评价各参数对DMD和BMD的鉴别诊断价值。结果除股薄肌外,DMD组其余肌肉FF值均高于BMD组和对照组,差异有统计学意义(P<0.05);除缝匠肌、长收肌和股薄肌外,BMD组其余肌肉FF值均高于对照组,差异有统计学意义(P<0.05)。DMD组T2值均高于BMD组和对照组,差异有统计学意义(P<0.05);除缝匠肌和股薄肌外,BMD组其余肌肉T2值均高于对照组,差异均有统计学意义(P<0.05)。除DMD组臀大肌(r=0.137,P=0.229)、BMD组长收肌(r=0.314,P=0.066)和股薄肌(r=0.285,P=0.097)外,两组其余肌肉T2值与FF值间均呈正相关(P<0.05)。FF值及T2值的ROC曲线下面积分别为0.878(0.807~0.949)和0.846(0.758~0.935)。结论MR功能成像可提高DMD与BMD的鉴别诊断效能,具有重要的临床应用价值。Purpose Conventional MRI sequences could not accurately reflect the differences between Duchenne muscular dystrophy(DMD)and Becker muscular dystrophy(BMD).This paper discusses the value of MR functional sequence in differential diagnosis of DMD and BMD.Materials and Methods Using a prospective study,79 patients with DMD and 35 patients with BMD confirmed by clinical biopsy and/or genetic testing were included,15 healthy volunteers(control group)were also included during the same period,all subjects were evaluated using IDEAL-IQ and T2 mapping,the fat fraction(FF)and T2 values of the hip and thigh muscles(12 pieces in total)were measured respectively,the differences of each parameter between DMD group,BMD group and control group were compared,the correlation between FF value and T2 value in DMD group and BMD group was analyzed,the value of each parameter in differential diagnosis of DMD and BMD was evaluated by ROC curve.Results In 12 muscles,except the gracilis,FF values of other muscles in DMD group were higher than those of BMD group and control group;except the sartorius,adductor longus and gracilis,FF values of other muscles in BMD group were higher than those in control group,with statistically significant difference(P<0.05).T2 values of DMD group were higher than those of BMD group and control group;except the sartorius and gracilis,T2 values of other muscles in BMD group were higher than those of control group,with statistically significant difference(P<0.05).Except gluteus maximus in DMD group(r=0.137,P=0.229)and adductor longus(r=0.314,P=0.066)and gracioris muscle(r=0.285,P=0.097)in BMD group,there was a positive correlation between the T2 value and FF value of other muscles in the two groups(all P<0.05).The area under ROC curve for FF and T2 values were 0.878(0.807-0.949)and 0.846(0.758-0.935).Conclusion Functional MRI can improve the differential diagnosis efficiency between DMD and BMD,with important clinical application value.

关 键 词：杜氏肌营养不良 贝氏肌营养不良 磁共振成像 病理学 外科 诊断 鉴别 

分 类 号：R445.2[医药卫生—影像医学与核医学] R746.2[医药卫生—诊断学]