[磁共振成像 T2 映射可反映皮肌炎或多发性肌炎患者的疾病状态]。

F Zhang, J Xu, X X Wang, Y Q Cheng, W Chen
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Disease status was evaluated using a panel of tools: myositis disease activity assessment tool-muscle (MDAAT-muscle), myositis disease activity assessment tool-whole (MDAAT-all), health assessment questionnaire (HAQ), medical outcomes study health survey short form-36 item (SF-36), hand muscle strength test (MMT-8) score, and MRI T<sub>2</sub> mapping of muscle (22 muscles in the pelvis and thighs) T<sub>2</sub> values. The results showed that in the myositis group, the measurements for CK, ESR, CRP, complement C3, and complement C4 were 457.2 (165.6, 1 229.2) IU/L, 20 (10, 42) mm/1h, 3.25 (2.38, 10.07) mg/L, 0.90 (0.83, 1.06) g/L, and 0.18 (0.14, 0.23) g/L, respectively. The scores for MMT-8, MDAAT-muscle, MDAAT-all, HAQ, and SF-36 were 57.12±16.23, 5.34 (4.00, 6.00), 34.63±12.62, 1.55 (0.66, 2.59), and 44.66±7.98, respectively. 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引用次数: 0

摘要

本研究旨在探讨磁共振成像(MRI)T2图在皮肌炎(DM)和多发性肌炎(PM)评估中的价值。研究收集并分析了昆明医科大学第一附属医院风湿免疫科2016年10月至2017年12月的33例确诊病例(肌酶组)和8名健康志愿者(健康对照组)。对肌苷组的多个参数进行了量化,包括肌酸激酶(CK)、红细胞沉降率(ESR)、C反应蛋白(CRP)、补体C3和补体C4。采用一系列工具对疾病状态进行评估:肌炎疾病活动评估工具-肌肉(MDAAT-muscle)、肌炎疾病活动评估工具-全身(MDAAT-all)、健康评估问卷(HAQ)、医疗结果研究健康调查短表-36项(SF-36)、手部肌力测试(MMT-8)评分以及肌肉(骨盆和大腿的22块肌肉)磁共振成像T2图T2值。结果显示,肌炎组的肌酸激酶、血沉、CRP、补体C3和补体C4的测量值分别为457.2(165.6,1 229.2)IU/L、20(10,42)mm/1h、3.25(2.38,10.07)mg/L、0.90(0.83,1.06)g/L和0.18(0.14,0.23)g/L。MMT-8、MDAAT-muscle、MDAAT-all、HAQ 和 SF-36 评分分别为 57.12±16.23、5.34(4.00,6.00)、34.63±12.62、1.55(0.66,2.59)和 44.66±7.98。与健康对照组相比,DM 或 PM 患者骨盆和大腿所有 22 块肌肉的 T2 值均明显升高[(54.99±11.60)ms vs. (36.62±1.66)ms,P0.001],其中以坐骨肌、髂腰肌、梨状肌、臀小肌和臀中肌的病变最为严重。肌炎组的肌肉 T2 总值与肌酸激酶、肌肉 MDAAT、全部 MDAAT 和 HAQ 呈正相关(r 分别为 0.461、0.506、0.347 和 0.510,均为 P0.05)。补体 C4、SF-36 和 MMT-8 评分之间呈负相关(r=-0.424、-0.549 和 -0.686,均为 P0.05)。总之,本研究的结果表明,磁共振成像 T2 映像可以客观地反映 DM 和 PM 的疾病状态。
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[Magnetic resonance imaging T2 mapping could reflect disease status in patients with dermatomyositis or polymyositis].

This study aimed to explore the value of magnetic resonance imaging (MRI) T2 mapping in the assessment of dermatomyositis (DM) and polymyositis (PM). Thirty-three confirmed cases (myosin group) and eight healthy volunteers (healthy control group) at the Department of Rheumatology and Immunology, the First Affiliated Hospital of Kunming Medical University, from October 2016 to December 2017, were collected and analyzed. Multiple parameters of the myosin group were quantified, including creatine kinase (CK), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), complement C3, and complement C4. Disease status was evaluated using a panel of tools: myositis disease activity assessment tool-muscle (MDAAT-muscle), myositis disease activity assessment tool-whole (MDAAT-all), health assessment questionnaire (HAQ), medical outcomes study health survey short form-36 item (SF-36), hand muscle strength test (MMT-8) score, and MRI T2 mapping of muscle (22 muscles in the pelvis and thighs) T2 values. The results showed that in the myositis group, the measurements for CK, ESR, CRP, complement C3, and complement C4 were 457.2 (165.6, 1 229.2) IU/L, 20 (10, 42) mm/1h, 3.25 (2.38, 10.07) mg/L, 0.90 (0.83, 1.06) g/L, and 0.18 (0.14, 0.23) g/L, respectively. The scores for MMT-8, MDAAT-muscle, MDAAT-all, HAQ, and SF-36 were 57.12±16.23, 5.34 (4.00, 6.00), 34.63±12.62, 1.55 (0.66, 2.59), and 44.66±7.98, respectively. T2 values were significantly higher in all 22 muscles of the pelvis and thighs of patients with DM or PM compared with the healthy controls [(54.99±11.60)ms vs. (36.62±1.66)ms, P<0.001], with the most severe lesions in the satrorius, iliopsoas, piriformis, gluteus minimus, and gluteus medius muscles. The total muscle T2 value in the myositis group was positively correlated with CK, MDAAT-muscle, MDAAT-all, and HAQ (r=0.461, 0.506, 0.347, and 0.510, respectively, all P<0.05). There was a negative correlation between complement C4, SF-36, and MMT-8 scores (r=-0.424, -0.549, and -0.686, respectively, all P<0.05). Collectively, the findings from this study suggest that MRI T2 mapping can objectively reflect the disease status of DM and PM.

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