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KMID : 0388220130200050297
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Journal of the Korean Rheumatism Association
2013 Volume.20 No. 5 p.297 ~ p.302
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The Utility of Magnetic Resonance Imaging in Inflammatory Myopathy
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Kim Jin-Ju
Lee Seung-Hun
Paik Seung-Sam
Yoo Dae-Hyun
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Abstract
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Objective. The idiopathic inflammatory myopathies (IIMs) are chronic systemic connective tissue diseases. The muscle biopsy is a definitive diagnostic tool but blind biopsy some-times produces to negative results. Magnetic resonance imaging (MRI) as a tool for early diagnosis, guidance for biopsy, assessing extent of lesions and monitoring therapy in IIMs has been reported. The aim of this study is to as-sess the association of thigh inflammation through MRI and biopsy specimens with clinical findings. Methods. Sixty patients diagnosed with dermatomyositis (DM) or polymyositis (PM) from 2004 to 2011 in one cen-ter of rheumatology were enrolled. We reviewed clinical, laboratory, histopathologic and MRI of thigh data at ini-tial diagnosis. The inflammation grades by MRI and histo-pathology of muscles were evaluated through 4-point scor-ing systems. Results. The laboratory findings for aldolase and CK dif-fered significantly between DM patients (68.3%) and PM patients (31.7%). Fasciitis was detected by MRI in 43.3% of patients, of whom 88.5% had DM (p＜0.05). The fas-ciitis was also associated with myalgia (p＜0.05). Almost all MRI findings were symmetric except for two patients. The mean of total signal intensity was higher in patients with decreased muscle power. The signal intensity of af-fected muscle was slightly associated with muscle enzymes and histopathologic grading. Conclusion. Fasciitis was observed more in DM patients. MRI findings were associated with muscle enzymes and histopathologic grading. Signal intensity on MRI may be useful for measurement of disease activity in acute IIMs. The noninvasive nature and high sensitivity of muscle in-flammation suggest that MRI images should be considered prior to muscle biopsy and treatment of IIMs
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KEYWORD
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Inflammatory myopathy , MRI
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