The Diagnostic Value of MR IVIM and T2 Mapping in Differentiating Autoimmune Myositis From Muscular Dystrophy

Ran, Jun; Yin, Cuilin; Liu, Chanyuan; Li, Yitong; Hou, Bowen; Morelli, John N.; Dai, Bin; Li, Xiaoming

doi:10.1016/j.acra.2020.04.022

Cited by 8 publications

(10 citation statements)

References 19 publications

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“…Ran et al compared patients with autoimmune myositis (eg, dermatomyositis and polymyositis) to patients with muscular dystrophies and found significant differences of D and f between these groups. 83 Patients with autoimmune myositis tended to have higher D, likely due to the underlying edema, and a lower perfusion fraction. D* was reduced in the quadriceps of patients with dermatomyositis, 74 and in the lateral compartment of the leg in patients with PAD, which could be related to stiffening of the arterioles and capillaries.…”

Section: Results In Healthy Individualsmentioning

confidence: 97%

“…Even if the study included patients, those with hepatic lesions, tumors, or cervical lesions are not likely to exhibit pathologic changes in muscle. To date, there have been six studies to evaluate conditions that involve pathologies that result in changes to skeletal muscle, including evaluation of children with juvenile idiopathic arthritis, 67 and adolescent idiopathic scoliosis (AIS), 80 in addition patients with myopathies including dermatomyositis, 74,83 polymyositis, and muscular dystrophy, 83 and finally patients with peripheral artery disease. 75 Federau et al investigated IVIM parameters at rest and in response to exercise in patients with AIS.…”

Section: Results In Healthy Individualsmentioning

confidence: 99%

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Intravoxel Incoherent Motion Magnetic Resonance Imaging in Skeletal Muscle: Review and Future Directions

Englund

Reiter

Shahidi

et al. 2021

Magnetic Resonance Imaging

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Throughout the body, muscle structure and function can be interrogated using a variety of noninvasive magnetic resonance imaging (MRI) methods. Recently, intravoxel incoherent motion (IVIM) MRI has gained momentum as a method to evaluate components of blood flow and tissue diffusion simultaneously. Much of the prior research has focused on highly vascularized organs, including the brain, kidney, and liver. Unique aspects of skeletal muscle, including the relatively low perfusion at rest and large dynamic range of perfusion between resting and maximal hyperemic states, may influence the acquisition, postprocessing, and interpretation of IVIM data. Here, we introduce several of those unique features of skeletal muscle; review existing studies of IVIM in skeletal muscle at rest, in response to exercise, and in disease states; and consider possible confounds that should be addressed for musclespecific evaluations. Most studies used segmented nonlinear least squares fitting with a b-value threshold of 200 sec/mm 2 to obtain IVIM parameters of perfusion fraction (f), pseudo-diffusion coefficient (D*), and diffusion coefficient (D). In healthy individuals, across all muscles, the average AE standard deviation of D was 1.46 AE 0.30 Â 10 À3 mm 2 /sec, D* was 29.7 AE 38.1 Â 10 À3 mm 2 /sec, and f was 11.1 AE 6.7%. Comparisons of reported IVIM parameters in muscles of the back, thigh, and leg of healthy individuals showed no significant difference between anatomic locations. Throughout the body, exercise elicited a positive change of all IVIM parameters. Future directions including advanced postprocessing models and potential sequence modifications are discussed. Level of Evidence: 2 Technical Efficacy: Stage 2

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Section: Results In Healthy Individualsmentioning

confidence: 97%

Section: Results In Healthy Individualsmentioning

confidence: 99%

Intravoxel Incoherent Motion Magnetic Resonance Imaging in Skeletal Muscle: Review and Future Directions

Englund

Reiter

Shahidi

et al. 2021

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

“…This is the first study to evaluate the role of T2-mapping and FF in SM. Evidence of the construct and criterion validity of T2-mapping and FF in IIM is emerging [ 25 – 27 ]. In this study, T2-mapping times were associated with radiologist-assessed presence of muscle oedema, providing initial support for the use of quantitative sMRI sequences in the assessment of SM.…”

Section: Discussionmentioning

confidence: 99%

“…Quantitative measures of skeletal myopathy are emerging, namely T2-mapping, as a measure of oedema, and fat fraction (FF) to quantify fatty muscle infiltration and measure damage [ 25 ]. Quantitation of T2-mapping times, muscle volume and FF have recently been shown to correlate with radiologist assessment scores, muscle strength and distinguish IIM patients from healthy controls and patients with muscular dystrophy [ 26 , 27 ]. The role of T2-mapping and FF calculations in SSc has not been evaluated.…”

Section: Introductionmentioning

confidence: 99%

Using magnetic resonance imaging to map the hidden burden of muscle involvement in systemic sclerosis

et al. 2022

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Background Skeletal muscle can be directly affected by systemic sclerosis (SSc); however, a significant burden of SSc-associated myopathy is undetected because clinical parameters such as weakness and creatine kinase (CK) are unreliable biomarkers of muscle involvement. This study presents qualitative and quantitative magnetic resonance imaging (MRI) findings that quantify the prevalence of myopathy and evaluate any association between skeletal and cardiac muscle involvement in SSc. Methods Thirty-two patients with SSc who fulfilled the 2013 American College of Rheumatology/European League Against Rheumatism classification criteria underwent skeletal muscle MRI in addition to cardiac MRI. Skeletal muscles were independently assessed by two musculoskeletal radiologists for evidence of oedema, fatty infiltration and atrophy. Skeletal muscle T2 mapping times and percentage fat fraction were calculated. Linear regression analysis was used to evaluate the clinical and myocardial associations with skeletal muscle oedema and fatty infiltration. Cardiac MRI was performed using post gadolinium contrast imaging and parametric mapping techniques to assess focal and diffuse myocardial fibrosis. Results Thirteen participants (40.6%) had MRI evidence of skeletal muscle oedema. Five (15.6%) participants had fatty infiltration. There was no association between skeletal muscle oedema and muscle strength, creatine kinase, inflammatory markers or fibroinflammatory myocardial disease. Patients with skeletal muscle oedema had higher T2-mapping times; there was a significant association between subjective assessments of muscle oedema and T2-mapping time (coef 2.46, p = 0.02) and percentage fat fraction (coef 3.41, p = 0.02). Diffuse myocardial fibrosis was a near-universal finding, and one third of patients had focal myocardial fibrosis. There was no association between skeletal myopathy detected by MRI and burden of myocardial disease. Conclusions MRI is a sensitive measure of muscle oedema and systematic assessment of SSc patients using MRI shows that myopathy is highly prevalent, even in patients without symptoms or other signs of muscle involvement. Similarly, cardiac fibrosis is highly prevalent but occurs independently of skeletal muscle changes. These results indicate that novel quantitative MRI techniques may be useful for assessing sub-clinical skeletal muscle disease in SSc.

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“…Furthermore, cerebrospinal fluid lactate levels proved to be an independent predictor of stroke outcome [ 13 , 19 ]. Previous studies have shown that myositis is associated with changes in serum concentrations of various enzymes and metabolites such as lactate [ 10 , 20 ]. Currently, the diagnosis of myositis relies on histopathologic evaluation via muscle biopsy that necessarily requires the identification of the muscle portion that is most severely affected.…”

Section: Introductionmentioning

confidence: 99%

Chemical Exchange Saturation Transfer for Lactate-Weighted Imaging at 3 T MRI: Comprehensive In Silico, In Vitro, In Situ, and In Vivo Evaluations

et al. 2022

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Based on in silico, in vitro, in situ, and in vivo evaluations, this study aims to establish and optimize the chemical exchange saturation transfer (CEST) imaging of lactate (Lactate-CEST—LATEST). To this end, we optimized LATEST sequences using Bloch–McConnell simulations for optimal detection of lactate with a clinical 3 T MRI scanner. The optimized sequences were used to image variable lactate concentrations in vitro (using phantom measurements), in situ (using nine human cadaveric lower leg specimens), and in vivo (using four healthy volunteers after exertional exercise) that were then statistically analyzed using the non-parametric Friedman test and Kendall Tau-b rank correlation. Within the simulated Bloch–McConnell equations framework, the magnetization transfer ratio asymmetry (MTRasym) value was quantified as 0.4% in the lactate-specific range of 0.5–1 ppm, both in vitro and in situ, and served as the imaging surrogate of the lactate level. In situ, significant differences (p < 0.001) and strong correlations (τ = 0.67) were observed between the MTRasym values and standardized intra-muscular lactate concentrations. In vivo, a temporary increase in the MTRasym values was detected after exertional exercise. In this bench-to-bedside comprehensive feasibility study, different lactate concentrations were detected using an optimized LATEST imaging protocol in vitro, in situ, and in vivo at 3 T, which prospectively paves the way towards non-invasive quantification and monitoring of lactate levels across a broad spectrum of diseases.

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The Diagnostic Value of MR IVIM and T2 Mapping in Differentiating Autoimmune Myositis From Muscular Dystrophy

Cited by 8 publications

References 19 publications

Intravoxel Incoherent Motion Magnetic Resonance Imaging in Skeletal Muscle: Review and Future Directions

Intravoxel Incoherent Motion Magnetic Resonance Imaging in Skeletal Muscle: Review and Future Directions

Using magnetic resonance imaging to map the hidden burden of muscle involvement in systemic sclerosis

Chemical Exchange Saturation Transfer for Lactate-Weighted Imaging at 3 T MRI: Comprehensive In Silico, In Vitro, In Situ, and In Vivo Evaluations

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