磁共振扩散张量成像对多发性肌炎/皮肌炎的临床应用价值  

Clinical value of diffusion tensor imaging in polymyositis and dermatomyositis

作　　者：蒋玮丽[1] 黄胤[2] 龙斌[1] 柏玉涵[1] 张蔚[1] 张东友[1] JIANG Weili;HUANG Yin;LONG Bin;BAI Yuhan;ZHANG Wei;ZHANG Dongyou(Department of Radiology,Wuhan No.1 Hospital,Wuhan 430022,China;Department of Dermatology,Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]武汉市第一医院放射科,武汉430022 [2]武汉市第一医院皮肤科,武汉430022

出　　处：《磁共振成像》2023年第7期103-107,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：武汉市医学科研项目(编号:WX21Z62)。

摘　　要：目的探讨磁共振扩散张量成像(diffusiontensorimaging,DTI)对多发性肌炎/皮肌炎(polymyositis/dermatomyositis,PM/DM)患者大腿肌肉的临床应用价值。材料与方法前瞻性招募2019年9月至2022年3月我院确诊的46例PM/DM患者(PM/DM组),同时招募同期32例无肌肉病变的健康志愿者(对照组)。比较PM/DM组双侧大腿水肿肌肉、未水肿肌肉及正常对照组(region of interest,ROI)区域的表观扩散系数(apparent diffusion coefficient,ADC)、各向异性分数(fractional anisotropy,FA)平均值的差异,采用单因素方差分析(analysis of variance,ANOVA)、受试者工作特征(receiver operating characteristic,ROC)曲线及Spearman秩相关分析对相关参数进行统计分析,P<0.05表示差异有统计学意义。结果PM/DM组水肿肌肉、未水肿肌肉及正常对照组的ADC值差异具有统计学意义(P<0.05),水肿肌肉的ADC值高于未水肿肌肉和对照组(P<0.05),但未水肿肌肉与对照组之间差异不具有统计学意义(P>0.05)。PM/DM组水肿肌肉、未水肿肌肉及正常对照组的FA值差异不具有统计学意义(P>0.05)。ADC值对PM/DM组水肿肌肉的诊断阈值为1.62×10-3mm2/s,敏感度为87.5%,特异度为85.0%,曲线下面积为0.869。相关性分析显示PM/DM组水肿肌肉平均ADC值与血清肌酸激酶(creatine kinase,CK)呈正相关(r=0.583,P<0.001),而PM/DM组水肿肌肉平均FA值与血清CK之间不存在显著相关性(P>0.05)。结论DTI可以对PM/DM患者水肿肌肉的病理改变特征进行定量分析,可在一定程度上反映疾病的活动程度,具有良好的辅助诊断价值。Objective:To investigate the diffusion tensor imaging(DTI)of thigh muscles in patients with polymyositis(PM)and dermatomyositis(DM).Materials and Methods:Forty-six patients with PM/DM diagnosed in our hospital from September 2019 to March 2022 were selected as PM/DM group.Thirty-two healthy volunteers who came to our hospital at the same time without muscle diseases were selected as control group.Apparent diffusion coefficient(ADC)and fractional anisotropy(FA)were compared among the PM/DM edema muscles,unaffected muscles(non-edema muscles)and normal muscles of ROI region.The one way analysis of variance test,receiver operating characteristic(ROC)curve and Spearman rank correlation analyses were used to analysis the mean ADC,FA of DTI in PM/DM group and control group.P values<0.05 were considered statistically significant.Results:The mean ADC value of edema muscles in the PM/DM group was higher on average and showed a statistically significant difference when compared with unaffected muscles and normal muscles(P<0.05),while the mean ADC value was no statistical difference between unaffected muscles and normal muscles(P>0.05).There was no significant difference in the mean FA value between the three groups(P>0.05).The optimal cut-off value of ADC between edema muscles and normal muscles was 1.62×10-3 mm2/s,sensitivity was 87.5%,specificity was 85.0%and AUC was 0.869.Correlation analysis showed that mean ADC value of edema muscles were positively correlated with creatine kinase(CK;r=0.583,P<0.001),but there was no significant correlation between mean FA value of edema muscles with CK(P>0.05).Conclusions:DTI can be used to quantitatively analyze pathological features of edema muscles in patients with PM/DM,DTI can be a good ability for diagnose PM/DM.

关 键 词：多发性肌炎 皮肌炎 磁共振成像 扩散张量成像 定量分析 诊断 

分 类 号：R658.2[医药卫生—外科学] R593.26[医药卫生—临床医学]