Contrast-enhanced Ultrasound in Dermatomyositis- and Polymyositis

Weber, Marc‐André; Jappe, Uta; Essig, Marco; Krix, Martin; Ittrich, Carina; Huttner, B. Hagen; Meyding‐Lamadé, Uta; Hartmann, Marius; Kauczor, Hans‐Ulrich; Delorme, Stefan

doi:10.1007/s00415-006-0318-5

Cited by 62 publications

(46 citation statements)

References 24 publications

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“…Several complications such as intraventricular hemorrhage (IVH), acute hydrocephalus, early hematoma expansion, and perihemorrhagic edema may occur during hospital stay and have been previously verified to independently impact outcome [2][3][4][5][6]. In addition, recent studies reported a high rate of cardiac complications presumably linked to a further increase in mortality of patients with intracranial hemorrhage [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Peak Troponin I Levels Are Associated with Functional Outcome in Intracerebral Hemorrhage

et al. 2018

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Background: Troponin I is a widely used and reliable marker of myocardial damage and its levels are routinely measured in acute stroke care. So far, the influence of troponin I elevations during hospital stay on functional outcome in patients with atraumatic intracerebral hemorrhage (ICH) is unknown. Methods: Observational single-center study including conservatively treated ICH patients over a 9-year period. Patients were categorized according to peak troponin I level during hospital stay (≤0.040, 0.041–0.500, > 0.500 ng/mL) and compared regarding baseline and hematoma characteristics. Multivariable analyses were performed to investigate independent associations of troponin levels during hospital stay with functional outcome – assessed using the modified Rankin Scale (mRS; favorable 0–3/unfavorable 4–6) – and mortality after 3 and 12 months. To account for possible confounding propensity score (PS)-matching (1: 1; caliper 0.1) was performed accounting for imbalances in baseline characteristics to investigate the impact of troponin I values on outcome. Results: Troponin elevations (> 0.040 ng/mL) during hospital stay were observed in 308 out of 745 (41.3%) patients and associated with poorer status on admission (Glasgow Coma Scale/National Institute of Health Stroke Scale). Multivariable analysis revealed troponin I levels during hospital stay to be independently associated with unfavorable outcome after 12 months (risk ratio [95% CI]: 1.030 [1.009–1.051] per increment of 1.0 ng/mL; p = 0.005), but not with mortality. After PS-matching, patients with troponin I elevation (≥0.040 ng/mL) versus those without had a significant higher rate of unfavorable outcome after 3 and 12 months (mRS 4–6 at 3 months: < 0.04 ng/mL: 159/265 [60.0%] versus ≥0.04 ng/mL: 199/266 [74.8%]; p < 0.001; at 12 months: < 0.04 ng/mL: 141/248 [56.9%] versus ≥0.04 ng/mL: 179/251 [71.3%]; p = 0.001). Conclusions: Troponin I elevations during hospital stay occur frequently in ICH patients and are independently associated with functional outcome after 3 and 12 months but not with mortality.

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Section: Introductionmentioning

confidence: 99%

Peak Troponin I Levels Are Associated with Functional Outcome in Intracerebral Hemorrhage

et al. 2018

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“…Power Doppler and contrast enhancement ultrasound have been found to show signs of increased perfusion in dermatomyositis and polymyositis. 2,3 This was also highlighted by Dr. Visser. Further prospective studies are needed to determine the diagnostic value of this technique, especially with regard to differentiating inflammatory myopathies from other neuromuscular disorders, or even to distinguish DM from PM based on the characteristics of power Doppler imaging combined with other ultrasound parameters.…”

Section: Replymentioning

confidence: 83%

High‐resolution power doppler sonography in inflammatory myopathy

Visser¹,

Arts²,

Pillen³

et al. 2009

Muscle and Nerve

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“…However, although T2-weighted hyperintensities, i.e., edema-like changes [1], in muscles may be an early sign of a myositis, they may be misleading, because they also occur in other conditions including metabolic or traumatic changes, neuropathies, muscular dystrophies, myotonic dystrophy, necrotic changes such as rhabdomyolysis or diabetic muscle infarction or even physical exercise [24,25,46,47,51]. CEUS demonstrates in patients with typical histological features of PM and DM a significantly increased muscle perfusion in both subsets with comparable accuracy to MRI [29,52]. Since edemalike changes are detected in most patients with myositis, and in these are associated with increased perfusion detected by CEUS [29,52], both findings are suspicious for a myositis.…”

Section: Diagnosismentioning

confidence: 92%

Quantitative evaluation of muscle perfusion with CEUS and with MR

2007

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Functional imaging might increase the role of imaging in muscular diseases, since alterations of muscle morphology alone are not specific for a particular disease. Perfusion, i.e., the blood flow per tissue and time unit including capillary flow, is an important functional parameter. Pathological changes of skeletal muscle perfusion can be found in various clinical conditions, such as degenerative or inflammatory myopathies or peripheral arterial occlusive disease. This article reviews the theoretical basics of functional radiological techniques for assessing skeletal muscle perfusion and focuses on contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) techniques. Also, the applications of microvascular imaging, such as in detection of myositis and for discriminating myositis from other myopathies or evaluating peripheral arterial occlusive disease, are presented, and possible clinical indications are discussed. In conclusion, dedicated MR and CEUS methods are now available that visualize and quantify (patho-)physiologic information about microcirculation within skeletal muscles in vivo and hence establish a useful diagnostic tool for muscular diseases.

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Contrast-enhanced Ultrasound in Dermatomyositis- and Polymyositis

Abstract: Increased skeletal muscle perfusion measured by CEUS could serve as an additional measurer for the diagnosis of an inflammatory myopathy.

Cited by 62 publications

References 24 publications

Peak Troponin I Levels Are Associated with Functional Outcome in Intracerebral Hemorrhage

Peak Troponin I Levels Are Associated with Functional Outcome in Intracerebral Hemorrhage

High‐resolution power doppler sonography in inflammatory myopathy

Quantitative evaluation of muscle perfusion with CEUS and with MR

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