Duchenne型肌营养不良儿童大腿肌肉脂肪含量的MRS研究  

MR Spectroscopic Technique in Quantitative Analysis of Thigh Muscle Fatty Content in Boys with Duchenne Muscular Dystrophy

作　　者：方雪琳 陈嘉坤 路新国[2] 方佃刚[1] 孟宪磊[1] 曾洪武[1] 李志勇[1] FANG Xuelin;CHEN Jiakun;LU Xinguo(Department of Radiology,Shenzhen Children's Hospital,Shenzhen,Guangdong Province 518026,P.R.China)

机构地区：[1]深圳市儿童医院放射科,518026 [2]深圳市儿童医院神经内科,518026 [3]汕头大学医学院,515041

出　　处：《临床放射学杂志》2022年第12期2285-2289,共5页Journal of Clinical Radiology

基　　金：深圳市医疗卫生三名工程项目(编号:SZSM202011005)。

摘　　要：目的探讨快速多回波T_(2)校正单体素波谱技术(HISTO-MRS)定量分析Duchenne型肌营养不良(DMD)患儿大腿肌肉脂肪含量的可行性及准确性,论证其诊断价值。方法纳入84例DMD患儿和36例年龄相匹配的健康男童,先行大腿T_(1)WI和多回波水脂分离技术(ME-Dixon)序列扫描,于右侧大收肌和股外侧肌行HISTO-MRS检查,自动得出HISTO-脂肪分数(FF)值。在ME-Dixon的FF图上手动勾画肌肉轮廓得到ME-Dixon-FF值。在轴位T_(1)WI图像上对大腿肌肉进行脂肪浸润程度半定量分级。采用Bland-Altman方法评估右侧大收肌两次HISTO-FF值的一致性,独立样本t检验比较DMD组和对照组HISTO-FF值的差异;最后分别评估DMD组HISTO-FF值与T_(1)WI脂肪浸润分级、ME-Dixon-FF值的相关性。结果大收肌HISTO-FF值95.2%数据点在95%一致性界限内,组内相关系数(ICC)为0.973。DMD组大收肌和股外侧肌的HISTO-FF值明显高于对照组(29.7%±22.0%vs.2.9%±1.9%,23.1%±20.0%vs.2.4%±2.0%,P均<0.001)。大收肌和股外侧肌的HISTO-FF值与T_(1)WI脂肪浸润程度分级高度正相关(r=0.793;r=0.881;P均<0.001),与ME-Dixon-FF值亦呈高度正相关(r=0.987;r=0.996;P均<0.001)。结论HISTO-MRS技术可快速准确测定DMD患儿大腿肌肉脂肪含量,对诊断疾病和评估脂肪浸润严重程度具有重要临床意义。Objective To explore the feasibility and accuracy of quantitative analysis of thigh muscle fat content in children with Duchenne muscular dystrophy(DMD)by HISTO-MRS,and to demonstrate its diagnostic value.Methods 84 children with DMD and 36 age-matched healthy boys were included.The thigh T_(1)WI and ME-Dixon sequences were scanned first,and HISTO-MRS was performed on the right adductor magnus and lateral vastus muscle,and the HISTO-FF value was obtained by manually drawing the muscle outline on the FF diagram of ME-Dixon.The degree of fat infiltration of thigh muscle was graded semi-quantitatively on axial T_(1)WI images.Bland-Altman method was used to evaluate the consistency of HISTO-FF value of adductor Magnus muscle.Independent sample t test was used to compare the difference of HISTO-FF value between DMD group and control group.Finally,the correlation between HISTO-FF value,T_(1)WI fat infiltration grade and ME-Dixon-FF value in DMD group was evaluated respectively.Results The HISTO-FF value of adductor Magnus was 95.2%.The data point was within 95%consistency,and the intra-group correlation coefficient(ICC)was 0.973.The HISTO-FF values of adductor magnus and lateral vastus muscle in the DMD group were significantly higher than those in the control group(29.7%±22.0%vs.2.9%±1.9%,23.1%±20.0%vs.2.4%±2.0%,P<0.001).The HISTO-FF value of adductor magnus muscle and lateral vastus muscle was positively correlated with the degree of T_(1)WI fat infiltration(r=0.793;r=0.881;P<0.001),and also positively correlated with ME-Dixon-FF value(r=0.987;r=0.996;P<0.001).Conclusions HISTO-MRS technique can quickly and accurately determine the fat content of thigh muscle in children with DMD,which has important clinical significance in diagnosing diseases and evaluating the severity of fat infiltration.

关 键 词：肌营养不良 杜氏 脂肪分数 磁共振成像 质子磁共振光谱 

分 类 号：R746.2[医药卫生—神经病学与精神病学]