Magnetic resonance imaging of skeletal muscles in idiopathic inflammatory myopathies of adults

The purpose of the study was to describe typical MRI findings in various types of idiopathic inflammatory myopathies in adulthood and to correlate the MRI with histopathological and electromyographic findings, and the serum creatine kinase (CK) activity. A third goal was to assess the diagnostic val...

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Bibliographic Details
Published in:	Journal of neurology Vol. 241; no. 5; pp. 306 - 314
Main Authors:	REIMERS, C. D, SCHEDEL, H, FLECKENSTEIN, J. L, NÄGELE, M, WITT, T. N, PONGRATZ, D. E, WOGL, T. J
Format:	Journal Article
Language:	English
Published:	Berlin Springer 01-03-1994
Subjects:	Adult Aged Aged, 80 and over Biological and medical sciences Creatine Kinase - blood Dermatomyositis - diagnosis Diseases of striated muscles. Neuromuscular diseases Edema - pathology Electromyography Female Gadolinium DTPA Granuloma - diagnosis Humans Inclusion Bodies - ultrastructure Lipomatosis - diagnosis Magnetic Resonance Imaging Male Medical sciences Middle Aged Muscles - pathology Myositis - diagnosis Neurology Organometallic Compounds Pentetic Acid - analogs & derivatives Sensitivity and Specificity Human Striated muscle disease Nervous system diseases Exploration Striated muscle Nuclear magnetic resonance imaging Inflammatory disease Myopathy
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Summary:	The purpose of the study was to describe typical MRI findings in various types of idiopathic inflammatory myopathies in adulthood and to correlate the MRI with histopathological and electromyographic findings, and the serum creatine kinase (CK) activity. A third goal was to assess the diagnostic value of the use of gadolinium-DTPA (Gd-DTPA). Fifty-eight patients (35 women, 23 men), aged 21-83 years (median age 59 years), suffering from idiopathic myositides (13 with acute and 45 chronic diseases; 25 with polymyositis, 14 with dermatomyositis, 8 with granulomatous and 11 with inclusion body myositides) were examined with MRI. Seventeen of them received an intravenous infusion of Gd-DTPA. Histopathological and MRI findings of 21 muscles of 18 patients were compared. MRI of skeletal muscles showed abnormal signal intensities in 56 (96.6%) of the 58 patients. MRI abnormalities were found more often than elevated CK activity (P < 0.001). The hyperintensity of T2-weighted images was more conspicuous than on T1-weighted images in 26 (44.8%) patients, indicating oedema-like abnormalities. MRI of 50 (86.2%) patients showed fat replacement. In acute myositides, oedema-like abnormalities were more often visible and in muscle lipomatosis less often visible than in chronic diseases (P < 0.05 each). In dermatomyositis oedema-like abnormalities were more and lipomatosis less frequent than in the other types of myositis (P < 0.005) and correlated with the acuteness of the disease.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0340-5354 1432-1459
DOI:	10.1007/bf00868438