Becker型肌营养不良下肢肌肉MRI分析

摘要

目的 探讨Becker型肌营养不良下肢肌肉的MRI特征.方法 回顾性分析2016-04—2018-05于河南省人民医院确诊的6例Becker型肌营养不良患者的临床资料及下肢肌肉MRI结果.结果 3例表现为典型的肢带型肌无力, MRI上其大腿肌肉表现为大收肌、股四头肌、股二头肌长头脂肪化较重, 而缝匠肌、长收肌、股薄肌、半腱肌相对保留, 其小腿腓肠肌存在不同程度的脂肪化改变;2例表现为活动后肌肉痉挛疼痛;1例仅表现为CK增高, 其大小腿肌肉未见明显脂肪浸润.结论 BMD中肌无力者下肢MRI主要表现为大腿大收肌、股四头肌、股二头肌长头脂肪化较重, 而缝匠肌、长收肌、股薄肌、半腱肌相对保留, 小腿的腓肠肌存在脂肪化改变;肌力正常者大小腿肌肉在MRI上可无明显脂肪化改变.%Objective To investigate the MRI features of lower limbs' muscles in BMD.Methods We retrospectively analyzed the clinical data and the MRI results of the lower limbs' muscles of 6 patients diagnosed for BMD in our hospital between April 2016 and May 2018.Results 3 patients showed typical weakness of the proximal limb muscles.On MRI, large adductor, quadriceps, and caput longum musculi bicipitis femoris were the most affected, while the sartorius muscle, the musculi adductor longus, gracilis and semitendinosus were relatively reserved, and the gastrocnemius were involved for various degrees of fatty infiltration;2 patients showed muscle pain after activities, a patient only showed an increase in CK, and no significant fatty infiltration was observed in the leg muscles.Conclusion The lower limbs' MRI of BMD with weakness is mainly characterized by heavier fatty degeneration in large adductor, quadriceps, and caput longum musculi bicipitis femoris, while sartorius muscle, musculi adductor longus, gracilis and semitendinosus are relatively reserved, and the changes of fatty infiltration in gastrocnemius can be found;Inconspicuous fatty infiltracation on MRI could be found in these BMD without weakness.