磁共振扩散张量成像定量分析在评价多发性肌炎和皮肌炎临床特征的应用

Application of Quantitative Analysis of Magnetic Resonance Diffusion Tensor Imaging in Evaluating Clinical Features of Polymyositis and Dermatomyositis

目的分析磁共振扩散张量成像定量(DTI)分析在评价多发性肌炎和皮肌炎(PM/DM)临床特征的应用。方法将本院自2017年3月-2019年3月收治的200例活动期PM/DM患者纳入PM/DM组,另筛选同期30例健康志愿者为对照组,所纳入患者均有双侧大腿DTI扫描结果,比较大腿肌肉前群、内群、后群肌肉组织中水肿肌肉、对照组(正常肌肉)、未受累肌肉ROI区域的平均扩散系数(ADC)、各向异性分数值(Fractional anisotropy,FA值)、本征值(λ1、λ2、λ3)。结果①各组不同肌肉组织A D C值比较差异有统计学意义(P<0.05);对照组、PM/DM水肿肌肉、PM/DM未受累肌肉均以VI处ADC值最高,对照组、PM/DM未受累肌肉以GA处ADC值最低,PM/DM水肿肌肉以SM处ADC值最低;组间比较PM/DM水肿肌肉A DC值均显著高于PM/DM未受累肌肉、对照组(P<0.05);②各组不同肌肉组织FA值比较差异有统计学意义(P<0.05),对照组、PM/DM水肿肌肉、PM/DM未受累肌肉均以ST FA值最高,AD FA值最低;但组间FA值比较差异均无统计学意义(P> 0.05);③各组大腿肌肉λ1均值>λ2>λ3 (P <0.05);组间比较PM/DM水肿肌肉λ1、λ2、λ3均值均显著高于PM/DM未受累肌肉、对照组(P<0.05)。结论 DTI或可基于PM/DM患者水肿肌肉的各向异性特征对病变肌肉的病理变化进行定量分析,值得临床重视。

Objective To analyze the application ofquantitativeanalysis of magnetic resonance diffusion tensor imaging(DTI) in the evaluation of clinical features of polymyositis and dermatomyositis(PM/DM). Methods A total of 200 active PM/DM patients admitted to the hospital from March 2017 to March 2019 were enrolled in PM/DM group. Another 30 healthy volunteers at the same time period were selected as control group. All included patients had. DTI scan results of bilateral thighs, and the average diffusion coefficient(ADC), fractional anisotropy(FA value) and eigenvalue(λ1, λ2, λ3) were compared among the edema muscles in the anterior group, inner group and posterior group muscle tissues, the control group(normal muscle) and the unaffected muscle ROI region. Results There was a statistically significant difference in the ADC value of different muscle tissues in each group(P<0.05). The ADC value at VI was the highest in control group, PM/DM edema muscle and PM/DM unaffected muscle, and the ADC value at GA was the lowest in control group and PM/DM unaffected muscle, and the ADC value at SM was the lowest in PM/DM edema muscle. The ADC value of PM/DM edema muscle was significantly higher than that in PM/DM unaffected muscle and control group(P<0.05). There was a statistically significant difference in the FA value of different muscle tissues in each group(P<0.05), and the FA value at ST was the highest and the FA value at AD was lowest in control group, PM/DM edema muscle and PM/DM unaffected muscle. There was no significant difference in the FA value between the groups(P>0.05). Thethigh muscles in each group showed mean value of λ1>λ2>λ3(P<0.05). The mean values of λ1, λ2 and λ3 of PM/DM edema musclewere significantly higher than those of PM/DM unaffected muscle and control group(P<0.05). Conclusion DTI may be based on the anisotropic characteristics of edema muscles in patients with PM/DM to quantitatively analyze the pathological changes of diseased muscles, which is worthy of clinical attention.