Acute rhabdomyolysis: evaluation with magnetic resonance imaging compared with computed tomography and ultrasonography

Abstract

Fifteen patients with acute rhabdomyolysis were evaluated with low field magnetic resonance (MR) imaging and the results compared with those obtained using computed tomography (CT) and ultrasonography (US). With MR imaging, abnormal muscles with areas of increased signal intensity were seen in every patient, which probably reflects increased water content or increased mobility of water molecules caused by inflammatory reaction and oedema in the injured and necrotic muscles. Computed tomography without intravenous contrast medium demonstrated abnormal muscles in most patients examined with this modality. The CT findings consisted of areas of focal hypodensity in muscles. With US, abnormal muscles were seen in less than half of the patients studied. The normal structure of striated muscle was focally disturbed and areas of both decreased and increased echogenicity were found. Magnetic resonance imaging had a higher sensitivity in the detection of abnormal muscles than CT or US (100%, 62% and 42%, respectively). The findings of all these modalities are non-specific, but together with the clinical and laboratory data they confirm the diagnosis of rhabdomyolysis. The information gained from imaging studies is useful in the assessment of the extent and distribution of rhabdomyolysis. The precise identification of affected muscle compartments by MR imaging is valuable when surgical fasciotomy is considered for treatment; the procedure can then be appropriately directed to the compartments with clearly abnormal muscles.

Rhabdomyolysis of the head and neck: computed tomography and magnetic resonance imaging findings

“…3 More recently, Jain et al reported low density of the lateral pterygoid muscles on CT with subsequent hyperintensity and contrast enhancement on MRI done several days later in a 28-year-old with psychiatric problems who was admitted to the hospital for an acetaminophen overdose. 4 CT and MRI findings of rhabdomyolysis in the extremities have also been reported, 9,10 and two types of rhabdomyolysis have been described. 9 Type I rhabdomyolysis presents with oedema and the affected muscles reveal homogeneous isointensity to hypointensity on T 1 -weighted images, homogeneous hyperintensity on T 2 -weighted and STIR images and homogeneous enhancement.…”

Skeletal muscle evaluation by MRI in a rabbit model of acute ischaemia

“…Review of medical records has shown that MR images can be used to effectively localise muscle lesions in rhabdomyolysis and assess extent [4,[7][8][9][10][11][12]. MRI has been shown to be more sensitive for detection of rhabdomyolysis skeletal muscle lesions than ultrasonography and CT [8].…”

Clinics in diagnostic imaging (179)

“…However, these are nonspecific imaging findings that can also be seen in pyomyositis and infiltrative intramuscular neoplasms. (7,10,11) On ultrasonography, affected muscle groups generally appear hypoechoic, with effacement of the normal striated architecture of the muscle fibres, although these findings are also nonspecific. (11,12) In the absence of relevant clinical history and laboratory markers, radiological findings of rhabdomyolysis may be difficult to distinguish from those of inflammatory myopathy, muscle infection, necrotising fasciitis or other conditions associated with myonecrosis such as diabetes mellitus or sickle cell crisis.…”