Duchenne型肌营养不良T2 mapping成像与临床运动功能的相关性

摘要

目的：通过分析Duchenne型肌营养不良（Duchenne muscular dystrophy，DMD）患者骨盆及大腿肌肉T2 mapping成像结果，探讨T2值与临床运动功能的相关性。方法对12名DMD患者进行临床运动功能评估（9 m步行时间、四阶梯时间、卧立位时间）和T2 mapping成像研究。通过Pearson相关和Spearman秩相关分析骨盆和大腿15块肌肉T2值与临床运动功能相关性。结果9 m步行中位时间为7.72 s（四分位间距时间为1.19 s）；四阶梯中位时间为4.0 s（四分位间距时间为2.92 s）；卧立位平均时间（7.73±1.21）s。大收肌拥有最高的T2值，长收肌拥有最短的T2值。长收肌（rs=0.818，P=0.001）、缝匠肌（rs=0.645， P=0.016）与9 m步行时间成正相关。股中间肌（rs=0.879，P<0.001）、股直肌（rs=0.867，P=0.001）、大收肌（rs=0.855，P=0.001）、臀大肌（rs=0.818，P=0.002）、股外侧肌（rs=0.709，P=0.011）、股二头肌长头（rs=0.612, P=0.030）、股二头肌短头（rs=0.924, P=0.017）、半腱肌（rs=0.576，P=0.041）均与四阶梯时间成正相关。大收肌（rs=0.776，P=0.014）、臀大肌（rs=0.760，P=0.017）、股内侧肌（rs=0.790，P=0.011）、股二头肌长头（rs=0.803，P=0.009）均与卧立位时间成正相关。结论 T2 mapping成像技术是一个客观定量敏感的评估DMD患者疾病进展的方法，大收肌可能是反应临床运动功能最理想的指标。%Objective To explore the correlation between T2 value and clinical motor function by analyzing T2 mapping of pelvic and thigh muscles in Duchenne muscular dystrophy (DMD).Methods Clinical motor function (9 m walking time, four step time, timed Gower score) in 12 patients with DMD and T2 mapping imaging were evaluated. Pearson correlation and spearman rank were used to analyze correlation between T2 value and clinical motor function of 15 pelvic and thigh muscles.Results The median time of 9 m walking time was 7.72 s (quarterback interval time was 1.19 s); the median time of four steps time was 4.0 s (quarterback interval time was 2.92 s); timed Gower score was (7.73±1.21) s. Great adductor had the highest T2 value, and long adductor had the shortest T2 value. Both long adductor (rs=0.818, P=0.818) and sartorius (rs=0.645,P=0.645) had a positive correlation with 9 m walking time. Vastus intermedius (rs=0.879,P<0.001), rectus femoris (rs=0.867,P=0.001), great adductor (rs=0.855,P=0.001), gluteus maximus (rs=0.818,P=0.002) and vastus lateralis muscle (rs=0.709, P= 0.011), biceps femoris muscle (rs=0.924,P=0.017) and semitendinosus (rs=0.576,P=0.041) were positively correlated with four steps time. Great adductor (rs=0.776,P=0.014), gluteus maximus (rs=0.760,P=0.017), medial vastus muscle (rs=0.790,P=0.011) and long head of biceps (rs=0.803,P=0.009) were positively correlated with timed Gower score.Conclusions T2 mapping imaging is an objective, quantitative and sensitive technology in assessing disease progression of DMD, and great adductor is probably the most ideal index in assessment of clinical movement function.