M-Dixon quant和T2-mapping对杜氏肌营养不良症患儿进展前期及进展期运动功能的评估  

Assessment of motor function in pre-progressive and progressive stages of Duchenne muscular dystrophy in children using M-Dixon quant and T2-mapping

作　　者：陈太雅 林洁琼 胡颖熠 黄杨 王景刚 方佃刚[2] 路新国[5] 李志勇[2] CHEN Taiya;LIN Jieqiong;HU Yingyi;HUANG Yang;WANG Jinggang;FANG Diangang;LU Xinguo;LI Zhiyong(China Medical University,Shenyang 110000,China;Department of Radiology,Shenzhen Children’s Hospital;School of Medicine,Shantou University;Department of Rehabilitation,Shenzhen Children’s Hospital;Department of Neurology,Shenzhen Children’s Hospital)

机构地区：[1]中国医科大学,沈阳110000 [2]深圳市儿童医院放射科 [3]汕头大学医学院 [4]深圳市儿童医院康复科 [5]深圳市儿童医院神经内科

出　　处：《国际医学放射学杂志》2024年第3期335-341,共7页International Journal of Medical Radiology

基　　金：深圳市医疗卫生三名工程项目(SZSM202011005);深圳市科技计划项目(JCYJ20230807093815031)。

摘　　要：目的探讨M-Dixon quant和T2-mapping技术评估杜氏肌营养不良症(DMD)患儿进展前期及进展期运动功能的价值,为精确评估DMD病情和监测随访提供合适的影像学工具。方法前瞻性收集40例经基因检测或组织病理活检确诊的DMD男性患儿,进展前期(<7岁)患儿20例,进展期(≥7岁)患儿20例。所有患儿均进行下肢M-Dixon quant和T2-mapping检查,观察进展前期及进展期患儿大腿肌肉的MRI表现,选取右侧大腿14块肌肉并测量其脂肪分数(FF)值和T2值。根据运动功能量表(MFM)评分对患儿进行运动功能评估并计算MFM总评分。采用Pearson相关分析2组患儿各肌肉FF值、T2值与MFM总评分的相关性(rFF,rT2)。结果进展前期DMD患儿大腿肌肉MRI表现为轻微脂肪浸润,随疾病进展表现为脂肪浸润程度加重。进展前期DMD患儿臀大肌、半膜肌、半腱肌FF值与MFM总评分均呈负相关(均P<0.05);除大收肌外,其余13块肌肉T2值与MFM总评分均呈负相关(均P<0.05),以股中间肌与MFM总评分的相关性最强。进展期DMD患儿14块肌肉FF值、T2值与MFM总评分均呈负相关(rFF为-0.877~-0.697,rT2为-0.968~-0.774,均P<0.05),以股外侧肌相关性最强。进展期DMD患儿每块肌肉的rT2均高于rFF。结论DMD患儿大腿肌肉受累有一定的进展规律。无论是进展前期还是进展期,相对于M-Dixon quant技术,T2-mapping技术能够更准确地反映疾病严重程度,疾病进展前期患儿的股中间肌和进展期患儿的股外侧肌T2值可作为评估DMD病情的良好指标。Objective To investigate the value of M-Dixon quant and T2-mapping in evaluating motor function in children with Duchenne muscular dystrophy(DMD)in the pre-progressive and progressive stages,providing appropriate imaging tools for accurate disease assessment and monitoring the follow-up.Methods Data from 40 male children diagnosed DMD through genetic detection or histopathological biopsy were prospectively collected.There were 20 children in the pre-progressive stage(<7 years old)and 20 children in the progressive stage(≥7 years old).All children underwent lower limb M-Dixon quant and T2-mapping examinations.MRI findings of thigh muscles in both stages were observed.The fat fraction(FF)and T2 values of 14 muscles in the right thigh were measured.Motor function was assessed using the motor function measure(MFM)scale,and the total MFM score was calculated.Pearson correlation analysis was used to evaluate the relationship between FF values,T2 values of each muscle,and the total MFM score in both groups(rFF,rT2).Results MRI showed slight fat infiltration in the thigh muscles of pre-progressive DMD children,which increased as the disease progressed.In the pre-progressive DMD children,the FF values of the gluteus maximus,semimembranosus,and semitendinosus muscles were negatively correlated with the total MFM score(all P<0.05).Except for the adductor magnus,the T2 values of the other 13 muscles were negatively correlated with the total MFM score(all P<0.05),with the vastus intermedius showing the strongest correlation.In the progressive DMD children,the FF values and T2 values of the 14 muscles were all negatively correlated with the total MFM score(rFF ranging from-0.877 to-0.697,rT2 ranging from-0.968 to-0.774,all P<0.05),with the vastus lateralis showing the strongest correlation.The rT2 values for each muscle were higher than the rFF in progressive DMD children.Conclusion Thigh muscle involvement in DMD children follows a certain progression pattern.Regardless of the stage,T2-mapping technique reflects disease sev

关 键 词：杜氏肌营养不良 T2-mapping 运动功能 磁共振成像 

分 类 号：R685[医药卫生—骨科学] R445.2[医药卫生—外科学]