MRI and ~ (31) P-MRS for the diagnosis of myopathy
|Course||Medical Imaging and Nuclear Medicine|
|Keywords||Myopathy MRI 31P-MRS|
Objective: To analyze facioscapulohumeral muscular dystrophy, limb-girdle muscular dystrophy, myopathy and MELAS syndrome MRI, resting and submaximal exercise performance after 31P-MRS, MRI and 31P-MRS study on myopathy diagnostic value. Methods: 37 cases of clinically confirmed myopathy patients and 17 age-matched, not professionally trained volunteers line sports resting right thigh cross-sectional, sagittal and coronal MRI scans, resting and Asia Extreme Sports immediately after, 10 and 15 minutes, 31P-MRS imaging. Because muscular dystrophy, myositis, myasthenia gravis and other cases too few checks uncooperative children not included in statistics and other 12 cases, this article only discusses the following 25 cases. Group A: facioscapulohumeral muscular dystrophy group (FSHD) 6 cases, 5 cases from two families, one case of disseminated; B Group: limb-girdle muscular dystrophy (LGMD) 6 cases, 2 cases from one family, 4 cases of disseminated; C Group: lipid storage myopathy (LSM) 8 例; D Group: mitochondrial myopathy (MELAS) 5 cases, 2 cases from one family. On 31P-MRS data for post-processing to obtain resting phosphocreatine PCr, inorganic phosphate Pi, inorganic phosphate and adenosine triphosphate ratio of Pi / ATP, inorganic phosphate and creatine phosphate ratio of Pi / PCr, creatine phosphate and adenosine triphosphate in ratio PCr / ATP, PH, adenosine diphosphate ADP, phosphorylation and mitochondrial ATP generation capacity PP mitochondria maximum production rate and the ratio of energy Q / Qmax and the generation rate after exercise PCr rate constant KPCr, PCr initial production rate ViPCr and mitochondria Qmax maximum energy production and other measurable parameters of mitochondrial function. Using multiple of the mean variance analysis LSD-t test to compare between disease group and the control group, the difference between whether the lesion group was statistically significant, and all data SPSS13.0 was used for statistical analysis. Results: MRI manifestations: lesions in 16 cases (64%) unenhanced MRI showed abnormalities, including seven cases of muscle atrophy, fatty infiltration of the 12 cases, seven cases of inflammatory infiltration and pseudo-hypertrophy of three cases. LGMD group showed a typical, including pseudo-hypertrophy of the quadriceps, the vastus medialis muscle and femoral muscles fatty infiltration and atrophy, gracilis, sartorius and semimembranosus relatively intact. I lesion group signs of abnormality between the presence of cross-ply muscle atrophy in the medial region B, C group, the vastus medialis muscle and femoral muscles District muscle fatty infiltration appeared in A, B, C group of patients; Issue muscle inflammatory infiltration in B, C group. So only by MRI, it is difficult to carry out a variety of muscle disease diagnosis. 31P-MRS performance: (1) Compared with control group: myopathy group were appeared PCr, PCr / ATP, PP, Qmax decreases, Pi / PCr, ADP increases, the statistical analysis of differences. Pi, Pi / ATP were not statistically different. There was no difference between group A parameter; B group showed elevated intracellular PH value were significantly different (t = 1.368, P = 0.032); C group showed KPCr higher (t = 2.729, P = 0.029) were statistically Learn the difference; D group showed Q / Qmax, ViPCr, KPCr decrease (t values ??were 3.012,5.84,3.15, P respectively 0.041,0.04,0.035) statistically significant. (2) lesions compared between groups: A, B groups PCr, Qmax, ViPCr, Kpcr, Q/Qmax5 kinds of parameters similar. Group C mitochondria TAC cycling capability index KPCr cycling capability slightly stronger than A, 'B, D group (P = 0.001,0.000,0.000), mitochondrial production capacity Qmax slightly lower than A, B group (P = 0.007, 0.366), higher than the D group (P = 0.036). A, B, C group of mitochondrial oxidative phosphorylation capacity index Q / Qmax, ViPCr similar. Group D PCr, Qmax, KPCr, Q / Qmax, ViPCr than other three groups have decreased significantly. Conclusion: Muscle MRI scan can be muscle morphology, signal changes found in muscle diseases. In addition LGMD with characteristic signs, other abnormal signs exist myopathy group cross, not the differential diagnosis of different myopathies. 31P-MRS determined through a variety of parameters before and after exercise muscle energy metabolism, mitochondrial dysfunction and oxidative phosphorylation capacity, the differential diagnosis of different myopathy of great value.