摘要
目的探讨核磁共振在炎症性肌病中的诊断价值,从而了解其是否可作为疗效评判的工具。方法对30例炎症性肌病患者及12例伴有肌肉酸痛的非炎症性肌病患者大腿肌群进行MRI扫描,对比其MRI表现;结合患者的肌酶、肌活检结果,比较3种检查的敏感性。结果①30例炎症性肌病患者全部行MRI检查,阳性者28例(2例阴性),占93.33%,急性起病的4例患者均阳性,占100%,对照组MRI全部阴性。②磁共振扫描炎症性肌病患者显示累及大腿肌前群28例,占93.33%;累及后群23例,占76.67%;累及内侧群5例,占16.67%。③实验组中MRI、CPK及肌活检3种检查方法的灵敏度分别为93.33%、76.67%和86.67%,其中急性起病者,MRI灵敏度达100%④复查的核磁共振图像显示原有病灶缩小或信号减弱。结论①MRI是一个诊断炎症性肌病的有效手段,快速回波序列和脂肪抑制快速翻转序列联合使用能提高诊断的正确率,减少漏诊率。②可反复使用,能作为临床判断疗效的工具之一。③能发现确切病灶,指导临床活检。
【Objective】To evaluate the utility of the magnetic resonance imaging（MRI） in diagnosis of inflammatory myopathies,so as to explore whether it can be used as a tool for curative efficacy evaluation.【Methods】30 patients with inflammatory myopathies and 12 patients with muscle soreness were scanned with MRI upon their thighs,the results of MRI were compared.The sensitivity of MRI,CPK and muscle biopsy for diagnosing inflammatory myopathies was compared.【Results】30 patients with inflammatory myopathies and 12 patients with muscle soreness were scanned with MRI upon their thighs.28 patients with inflammatory myopathies had abnomal MRI signals except 2 patients had normal manifestations.12 controls had normal manifestations on MRI.All of 4 patients with acute onset of test group had abnormal signals.The anterior group of thigh muscle with abnormal signal accounted for 93.33%（28 cases of 30）,the posterior group of thigh muscle with abnormal signal accounted for 76.67%（23 cases of 30）,the medial group accounted for16.67%（5 cases of 30）.The sensitivity of MRI for diagnosing myositis was no higher than that of the CPK and the muscle biopsy（P〈0.05）.Rechecked MRI showed the original lesions got smaller or vanished.【Conclusions】MRI may be an alternative effective method for the diagnosis of inflammatory myopathies,combining of Fast-echo sequences and Fat-suppressed fast turnover sequences can make the diagnosis more accurately.MRI can be regarded as one of the tools for evaluating the curative effect.Besides,it can be helpful to find the smaller lesions of muscles and lead to the accurate biopsy.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第24期3790-3792,3795,共4页
China Journal of Modern Medicine
