磁共振成像在诊断特发性炎症性肌病中的作用

A. A. Kolomeychuk
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摘要

特发性炎症性肌病(IIM)是一组慢性自身免疫性疾病,其特点是近端肌无力,并可能伴有一系列肌肉外临床表现。炎症性肌病有多种亚型,包括皮肌炎(DM)、多发性肌炎(PM)、免疫介导的坏死性肌病(IMNM)、散发性包涵体肌炎(sIBM)、抗合成酶综合征亚组重叠性肌炎(OM)和癌症相关性肌炎。考虑到该疾病的罕见性、临床表现的异质性、肌炎相关自身抗体(MAAs)和肌炎特异性自身抗体(MSAs)的检测方法和解释方面的困难,目前仍在继续寻找肌肉损伤的客观成像方法。这对于明确诊断、预测 IIM 的亚型和病例随访非常重要。磁共振成像(MRI)是最有前途的方法之一。本综述旨在研究核磁共振成像在评估肌肉损伤中的作用,特别是最典型的核磁共振成像发现,以及不同类型 IIM 的特征和更多临床病例。
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Capabilities of magnetic resonance imaging in the diagnosis of idiopathic inflammatory myopathies
Idiopathic inflammatory myopathies (IIM) are a group of chronic autoimmune conditions characterized by proximal muscle weakness and potentially accompanied by a range of extramuscular clinical manifestations. There are subtypes of IIM including dermatomyositis (DM), polymyositis (PM), immune-mediated necrotizing myopathy (IMNM), sporadic inclusion body myositis (sIBM), overlap myositis (OM) with subgroup of anti-synthetase syndrome (ASS) and cancer-associated myositis. Taking into account rarity of the disease, heterogeneity of clinical presentation, difficulties in detection methods and interpretation of myositis associated autoantibodies (MAAs) and myositis specific autoantibodies (MSAs), search for objective imaging methods of muscle damage continues. This is important to definitive diagnosis, predicting subtypes of IIM and case follow-up. One of the most promising methods is magnetic resonance imaging (MRI). The aim of the review was to examine the role of MRI in assessment muscle damage, in particular, most typical MRI-findings and there features in different types of IIM with further clinical cases.
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