皮肌炎的临床特征及MRI诊断价值

Clinical features of dermatomyositis and MRI diagnostic value

目的探讨皮肌炎的临床特征及MRI诊断价值。方法回顾性分析西安交通大学第二附属医院61例经临床确诊的皮肌炎患者的临床资料和影像学资料。结果 61例中,男15例,女46例,平均年龄45.3岁,病程10 d至12年。均具有不同程度的皮肤损害,伴肌无力和或肌痛者57例;皮肤、肌肉受累伴吞咽困难者4例,伴呼吸困难者2例,伴饮水呛咳者2例;18例合并两肺间质病变,1例合并干燥综合征,1例合并关节炎,1例合并横纹肌溶解症,1例合并肾损害和肝功不全。其中46例皮肌炎患者做了MRI检查,43例有异常表现,肌肉炎性水肿41例,皮下脂肪组织水肿37例,肌筋膜炎40例。结论皮肌炎临床表现复杂,具有一定的影像学特征,结合实验室肌酶、自身抗体检查、肌电图及皮肤肌肉活检,为临床提供诊断证据。MRI是诊断皮肌炎和评估其累及范围及进展程度的重要检查手段。

Objective To explore the clinical features of dermatomyositis and diagnostic value of MRI. Methods The clinical and imaging data of 61 patients with dermatomyositis were analyzed retrospectively. Results Among the 61 patients,there were 15 males and 46 females with the average age of 45. 3 years. The course of disease was 10 days to 12 years. All of them had different degrees of skin lesions, including 57 cases of myasthenia and or myalgia, 4 cases of dysphagia, 2 cases of dyspnea, and 2 cases of drinking water and coughing. There were 18 cases complicated with interstitial lung disease, 1 case complicated with Sjogren’s syndrome, 1 case complicated with arthritis, 1 case complicated with rhabdomyolysis, and 1 case complicated with kidney damage and liver insufficiency. MRI examination performed in 46 patients with dermatomyositis detected 43 cases of abnormal manifestations, 41 cases of muscle inflammatory edema, 37 cases of subcutaneous adipose tissue edema, and 40 cases of myofascitis. Conclusion The clinical manifestations of dermatomyositis are complex and have certain imaging features. Combined with the laboratory examinations of muscle enzymes and autoantibodies,electromyography,skin and muscle biopsy,they can provide clinical diagnostic evidence. MRI is an important means to diagnose and evaluate the extent and progression of dermatomyositis.