磁共振冠状位T2 DIXON TSE序列评价DMD患儿双侧臀部和大腿肌肉脂肪替代数量和等级的应用研究  

Application of MR Coronal T2-Weighted DIXON Turbo-Spin-Echo Sequence in Evaluating the Number and Grade of Fat Replacement in Bilateral Hips and Thigh Muscles of Children with DMD

作　　者：白万晶[1,2] 李学胜 李真林[3] 宁刚[1,2] 郭应坤[1,2] 许华燕[1,2] 伏川[1,2] BAI Wanjing;LI Xuesheng;LI Zhenlin;NING Gang;GUO Yingkun;XU Huayan;FU Chuan(Department of Radiology,West China Second University Hospital,Sichuan University,Chengdu Sichuan 610041,China;Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University),Ministry of Education,Chengdu Sichuan 610041,China;Department of Radiology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,China)

机构地区：[1]四川大学华西第二医院放射科,四川成都610041 [2]四川大学出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610041 [3]四川大学华西医院放射科,四川成都610041

出　　处：《中国医疗设备》2021年第10期126-131,共6页China Medical Devices

基　　金：国家自然科学基金青年科学基金项目(81901712)。

摘　　要：目的运用MRI T2 DIXON TSE序列,评价杜氏肌营养不良(Duchenne Muscular Dystrophy,DMD)患儿臀部和大腿肌肉脂肪替代的数量和等级,确定疾病的范围和严重程度。方法将66例DMD患儿按年龄分为3组,运用T2 DIXON TSE序列进行双侧臀部和大腿冠状位MRI扫描。两名医生对每例患儿22块对称性肌肉的脂肪替代程度进行盲法评分(0~4分),计算Kappa值并进行一致性检验。计算每例患儿22块肌肉总分S1和脂肪替代平均比例R1,得到综合等级G1。计算每块肌肉66例患儿总分S2和R2,得到G2。对S1和年龄、对不同年龄组G1的分布情况进行相关分析。对3组患儿受累肌肉数量、22块肌肉原始评分和累及病例数进行秩和检验。结果两名医生盲法评分具有中等一致性(Kappa=0.76,P<0.001)。S1和年龄存在正相关(r^(2)=0.49,P<0.001),回归方程为y=3.50x+3.15;G1在不同年龄组的分布呈正相关(r^(2)=0.45,P<0.001)。3组患儿受累肌肉数量差异无统计学意义(P>0.05),22块肌肉原始评分和累及病例数差异有统计学意义(P<0.001)。结论多块肌肉被脂肪替代,臀大肌受累最严重。T2 DIXON TSE序列能够评价DMD患儿臀部和大腿肌肉脂肪替代的范围和严重程度。Objective To evaluate the number and grade of fat replacement in hip and thigh muscles of children with Duchenne muscular dystrophy(DMD)using MRI T2-weighted DIXON turbo-spin-echo(TSE)sequence and to confirm the range and severity of this disease.Methods A total of 66 children with DMD were divided into three groups according to age,all of them underwent bilateral hips and thigh MRI by using coronal T2-weighted DIXON TSE sequence.The fat replacement degrees of 22 symmetrical muscles in each child were recorded by two independent observers using blind method(0-4 points).The Kappa value between the two observers was calculated and consistency test was used.For each child,S1(total score of 22 muscles)and R1(average ratio of fat replacement)were calculated.G1(comprehensive grade of fat replacement)was obtained reference to R1 and grading criterion.For every muscle,S2(total score of 66 cases)and R2(average ratio of fat replacement)were calculated.G2(comprehensive grade of fat replacement)was obtained reference to R2 and grading criterion.The distribution of S1,age,and G1 in different age groups were analyzed.;regression equation was obtained.Kruskal-Wallis test was used to compare numbers of affected muscles among the three age groups,the original scores of 22 muscles and numbers of affected cases.Results There was moderate consistency between the blind scores of two observers(Kappa=0.76,P<0.001).There was a positive correlation between S1 and age(r^(2)=0.49,P<0.001).The regression equation was y=3.50 x+3.15.The distribution of G1 in the three age groups was positively correlated(r^(2)=0.45,P<0.001).There was no significant difference in the number of affected muscles among the three groups(P>0.05).There was significant difference in the original score of 22 muscles and the number of cases involved(P<0.001).Conclusion Many muscles were replaced by fat and gluteus maximus was the most severely affected.T2 DIXON TSE sequence can evaluate the range and severity of fat replacement in hip and thigh muscles of children with

关 键 词：杜氏肌营养不良 磁共振成像 DIXON序列 脂肪替代 数量和等级 

分 类 号：R746.2[医药卫生—神经病学与精神病学]