A comparison of inflammatory myopathies at whole-body turbo STIR MRI

Cantwell, Colin P.; Ryan, M.; O’Connell, Martin; Cunningham, Patricia M.; Brennan, Darren D.; Costigan, Donal; Lynch, Timothy; Eustace, Stephen

doi:10.1016/j.crad.2004.06.027

Cited by 55 publications

(61 citation statements)

References 19 publications

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“…An homogeneous distribution of muscle inflammation was previously reported in polymiositis and inclusion body myositis, in contrast to the more focal oedema identified in DM 17. To the best of our knowledge, this is the first description of different patterns of muscle inflammation in JDM.…”

Section: Discussionsupporting

confidence: 54%

“…Whole-body (WB)-MRI screens the entire body with the advantage of evaluating much larger areas of muscles as well as subcutaneous fat tissue, thus providing a complete assessment of total inflammatory burden in IIMs patients. Even though its value has been suggested in a small series of adult IIMs16 17 and in a JDM case report,18 its real potential in childhood dermatomyositis has not yet been explored.…”

Section: Introductionmentioning

confidence: 99%

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Whole-body MRI in the assessment of disease activity in juvenile dermatomyositis

et al. 2013

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Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Whole-body MRI in the assessment of disease activity in juvenile dermatomyositis

et al. 2013

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“…Fatty replacement can be seen on T1-weighted sequences and muscle oedema can be seen on T2-weighted sequences with fat suppression such as the short tau inversion recovery (STIR) sequence (figure 3). Mimicking the typical clinical presentation, it has been reported that fatty replacement occurs preferentially in the deep finger flexors [43–46] and in the quadriceps femoris muscles [44, 45, 47]. A relative sparing of the rectus femoris [44, 45] and preferential fat accumulation within the medial head of gastrocnemius (in comparison with soleus and lateral gastrocnemius) have also been described [44, 45, 47].…”

Section: Ibm Diagnosis – New Insightsmentioning

confidence: 99%

“…A relative sparing of the rectus femoris [44, 45] and preferential fat accumulation within the medial head of gastrocnemius (in comparison with soleus and lateral gastrocnemius) have also been described [44, 45, 47]. Bone marrow oedema (interpreted as inflammation) on STIR images can also be seen, but inflammation is usually less prominent than fatty replacement [43, 44, 46]. Despite being well described, the differential diagnostic performance of the above MRI pattern has not been established and MRI features are not currently included in IBM diagnostic criteria.…”

Section: Ibm Diagnosis – New Insightsmentioning

confidence: 99%

Sporadic inclusion body myositis

Machado

Dimachkie

Barohn

2014

Current Opinion in Neurology

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Purpose of the review To describe new insights and developments in the pathogenesis, diagnosis and treatment of sporadic inclusion body myositis (IBM). Recent findings Various hypothesis about the pathogenesis of IBM continue to be investigated, including autoimmune factors, mitochondrial dysfunction, protein dyshomeostasis, altered nucleic acid metabolism, myonuclear degeneration and the role of the myostatin pathway. Serum autoantibodies against cytosolic 5′ nucleotidase 1A have been identified in IBM showing moderate diagnostic performance. The differential diagnostic value of histopathological features, including different protein aggregates, continues to be evaluated. MRI may also be of monitoring value in IBM. New therapeutic strategies are being tested in IBM patients, namely the up-regulation of the heat shock response and the antagonism of myostatin. Summary Recent important advances have occurred in IBM. These advances, including recent and ongoing clinical trials, may lead to earlier diagnosis and improved understanding and treatment of the disease. Despite improved knowledge, IBM continues to be a puzzling disease and the pathogenesis remains to be clarified. An interdisciplinary, bench to bedside translational research approach is crucial for the successful identification of novel treatments for this debilitating, currently untreatable disorder.

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“…Conventional MRI usually includes limited scanning of the proximal lower limb muscle girdle or scanning of the proximal upper limb girdle. In recent years, there have been reports that demonstrate the success of whole-body magnetic resonance imaging (WBMRI) through short tau inversion recovery (STIR) sequence in the diagnosis of PM / DM [7–9]. WBMRI has the advantage of documenting inflammatory myopathy of the whole body, including the psoas, intercostal, and neck muscles, which can not be done by conventional MRI.…”

Section: Introductionmentioning

confidence: 99%

An efficacy analysis of whole-body magnetic resonance imaging in the diagnosis and follow-up of polymyositis and dermatomyositis

et al. 2017

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ObjectivesTo evaluate the value of whole-body magnetic resonance imaging (WBMRI) in diagnosing muscular and extra muscular lesions in patients with polymyositis (PM) and dermatomyositis (DM).MethodsA retrospective analysis of WBMRI data from PM/DM patients who met the Bohan and Peter diagnostic criteria was performed. X2 test was used to compare the rate of positive diagnosis of newly diagnosed patients using WBMRI, serum creatine kinase test, and EMG. McNemar test was used to compare the performance of WBMRI and chest CT in detecting interstitial lung disease (ILD).ResultsThe study included 129 patients (30 PM cases and 99 DM cases). Of them, 81.4% (105/129) showed a visible inflammatory muscular edema on their WBMRI; 29.5% (38/129) had varying degrees of fatty infiltration (9 cases with clear muscular atrophy). Of the 66 newly diagnosed patients, the positive rates of WBMRI, muscle biopsy, serum creatine kinase test and EMG were 86.4% (57/66), 92.4% (61/66), 71.2% (47/66) and 71.1% (32/45), respectively. There was no significant difference in the positive rates between WBMRI and muscle biopsy (X2 = 1.28, P = 0.258). The WBMRI had a higher positive rate than both serum creatine kinase test (X2 = 4.53, P = 0.033) and EMG (X2 = 3.92, P = 0.047). In addition to muscular changes, WBMRI also detected interstitial lung disease (ILD) in 38 cases (29.5%), osteonecrosis in 15 cases (11.6%), and neoplastic lesions (5 malignant; 7 benign) in 12 cases (9.3%). Of the 61 patients who underwent routine chest CT examinations, the WBMRI and CT revealed ILD in 29 cases and 35 cases respectively. There was no significant difference in the sensitivity between WBMRI and CT (p = 0.146).ConclusionsWBMRI is a sensitive, non-invasive and efficient imaging method. It comprehensively displays the extent of muscular involvement in PM/DM patients, and it has the ability to diagnose other associated extra muscular diseases, such as ILD and systemic malignancy. WBMRI can also help screen steroid-induced osteonecrosis.

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A comparison of inflammatory myopathies at whole-body turbo STIR MRI

Cited by 55 publications

References 19 publications

Whole-body MRI in the assessment of disease activity in juvenile dermatomyositis

Whole-body MRI in the assessment of disease activity in juvenile dermatomyositis

Sporadic inclusion body myositis

An efficacy analysis of whole-body magnetic resonance imaging in the diagnosis and follow-up of polymyositis and dermatomyositis

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