MR imaging in children with dermatomyositis: musculoskeletal findings and correlation with clinical and laboratory findings.

MR imaging in children with dermatomyositis: musculoskeletal findings and correlation with clinical and laboratory findings. Research Abstract Details 

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MR imaging in children with dermatomyositis: musculoskeletal findings and correlation with clinical and laboratory findings. Abstract Text:

R J Hernandez,D B Sullivan,T L Chenevert,D R Keim,

OBJECTIVE. The purpose of this study was to describe the musculoskeletal MR findings in childhood dermatomyositis and to correlate MR findings with indicators of disease activity such as muscle strength and serum levels of muscle enzymes. SUBJECTS AND METHODS. This prospective study included 24 children: 19 children with dermatomyositis and five control subjects. The diagnosis of dermatomyositis was established by clinical findings and serum levels of muscle enzymes in all patients, electromyography in six patients, and biopsy in four patients. At the time of the initial MR evaluation, patients were classified on the basis of clinical findings as having active (n = 15) or inactive (n = 4) disease. A total of 44 MR evaluations of patients with dermatomyositis were included in the study: 19 initial MR examinations and 12 examinations repeated after 4-6 months of therapy in patients with active disease. An additional 13 examinations were performed on five patients. Conventional T1-weighted (SE 600/20) and T2-weighted (SE 2500/80) spin-echo and fat-suppressed MR images were obtained. The T2-weighted images (TE = 80) were used for comparison. In addition to the visual assessment, ratios between the signal intensity of muscles (gluteus, adductors, quadriceps, and hamstrings) and the signal intensity of subcutaneous fat in the same tomographic section were calculated. RESULTS. All patients with clinically active disease (n = 15) had abnormal findings on MR studies, whereas those with inactive disease (n = 4) had normal MR findings. Signal-intensity ratios of patients with active disease were greater than those in control subjects, whereas the ratios in patients with inactive disease were not different from those in control subjects. After 4-6 months of therapy, the average signal-intensity ratios of treated patients with repeated MR evaluations (n = 12) differed from ratios obtained before therapy in the same patients, but were not different from the ratios in control subjects. Other MR findings observed were perimuscular edema, enhancement of the chemical-shift artifact, and inflammatory changes of subcutaneous fat. Fat-suppressed imaging enhanced visualization of abnormalities. Markedly abnormal signal intensities of muscle were associated with marked elevations of serum levels of muscle enzymes; however, abnormal MR findings were visualized with normal serum levels of muscle enzymes. CONCLUSION. Findings of active childhood dermatomyositis on T2-weighted MR images include increased signal intensity in affected muscle, perimuscular edema, enhanced chemical-shift artifact, and increased signal intensity in subcutaneous fat. After therapy, signal intensity of muscle returns to normal. These MR findings are enhanced on fat-suppressed images.(ABSTRACT TRUNCATED AT 400 WORDS)

MR imaging in children with dermatomyositis: musculoskeletal findings and correlation with clinical and laboratory findings. Publishing Authors By Initials

RJ Hernandez,DB Sullivan,TL Chenevert,DR Keim,

For similar investigative techniques: epidemiologic methods: epidemiologic study characteristics as topic: epidemiologic studies: cohort studies: longitudinal studies: prospective studies research abstracts see: investigative techniques: epidemiologic methods: epidemiologic study characteristics as topic: epidemiologic studies: cohort studies: longitudinal studies: prospective studies research

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MR imaging in children with dermatomyositis: musculoskeletal findings and correlation with clinical and laboratory findings. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: AJR. American journal of roentgenology

VOLUME: 161

Page Numbers: 359-66

Journal Abbreviation:

ISSN: 0361-803X

DAY: 15

MONTH: Aug

YEAR: 1993

MR imaging in children with dermatomyositis: musculoskeletal findings and correlation with clinical and laboratory findings. Information

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LANGUAGE: eng

NlmUniqueID: 7708173

MR imaging in children with dermatomyositis: musculoskeletal findings and correlation with clinical and laboratory findings. Keywords Mesh Terms:

KEYWORDS: Prospective Studies

MESH TERMS: physiopathology

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Grant and Affiliation Information for MR imaging in children with dermatomyositis: musculoskeletal findings and correlation with clinical and laboratory findings.

AFFILIATION: Department of Radiology, University of Michigan Hospitals, Ann Arbor 48109.

Country: UNITED STATES

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MEDLINETA: AJR Am J Roentgenol

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