Objective To explore the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI ) in patients with progressive muscular dystrophy .Methods We enrolled 7 patients with known progressive muscular dystrophy (4 Becker muscle dystrophy ,BMD;3 limb-girdle muscle dystrophy ,LGMD) in this study .Both IVIM ,T1 WI and T2 STIR sequences were performed on both thighs of all the subjects .Slow ADC ,fast ADC and fraction of fast ADC (Ff ) were measured .Tl weighted images were used to assess the fat infiltration of their thigh muscles using a 0-5 modified version of Mercuri's scale .Slow ADC ,fast ADC and fraction of fast ADC (Ff) were compared among the fatty infiltration ,edematous muscle and unaffected muscle (neither edematous nor fatty infiltration muscles in patients ) .One-way analysis of variance was used for statistical analyses with a significance of P < 0 .05 . Results The mean slow ADC value of fatty infiltration . edematous muscle . and unaffected muscle was 0 .75+0.39,1 .14±0 .19,and 1.00±0 .11 (10 -3 mm2/s ) , respectively ( P < 0 .05 ) .The mean fast ADC value in the three groups was 7 .14±6 .51,13 .56±9 .67,and 4 .02±1.89 (10-3 mm2 /s ) , respectively (P< 0 .05 ) . There was no significant difference in the Ff values among the three groups ( P > 0 .05 ) .The mean slow ADC value in different grades of steatosis was 1 .00±0 .11, 0.98±0 .17, and 0 .50±0 .29 (10-3 mm2/s) , respectively ; the slow ADC value in heavy fat infiltration group differed significantly from that in the other two groups( P<0.05 ).Conclusion IVIM-DWI can be used to quantitatively evaluate the thigh diffusion and microcirculation characteristics of muscles in patients with PMD , make a quantitative analysis of edema and steatosis of the muscle .and reflect the degree of muscle steatosis .%目的 探讨体素内不相干运动扩散加权成像(IVIM-DWI)技术在进行性肌营养不良(PMD)中的应用价值.方法 对7例经肌肉活检证实的进行性肌营养不良(4例贝氏肌营养不良,3例肢带型肌营养不良)患者进行双侧大腿轴位T1 WI、T2 STIR和IVIM-DWI扫描,经后处理分析和测量得到IVIM参数值:快速弥散系数(Fast ADC值)、慢速弥散系数(Slow ADC值)、快速弥散分数(Ff值),并通过T1加权成像和改良的Mercuri分级评分法,对骨骼肌脂肪浸润程度进行0~5分的6级评分.采用单因素方差分析比较PM D患者中脂肪浸润肌肉、水肿肌肉、未受累肌肉各组间IV IM参数差异,并分析不同程度脂肪浸润肌肉间的IV IM参数差异.结果 PM D患者中脂肪浸润肌肉、水肿肌肉及未受累肌肉的Slow ADC值分别0.75±0.39、1.14±0.19、1.00±0.11(10-3 mm2/s),差异具有统计学意义(P<0.05),3组Fast ADC值分别约7.14±6.51、13.56±9.67、4.02±1.89(10-3 mm2/s),差异具有统计学意义(P<0.05).各组Ff值差异无统计学意义(P>0.05).按照改良的Mercuri分级评分将未受累肌肉和脂肪浸润肌肉分为3组:轻度脂肪浸润(0~1分)、中度脂肪浸润(2~3分)、重度脂肪浸润(4~5分),3组Slow ADC值分别1.00±0.11、0.98±0.17、0.50±0.29(10-3mm2/s),重度脂肪浸润组与另2组差异均具有统计学意义(P<0.05).结论 IVIM-DWI技术可用于定量评估肌肉水分子扩散及微血管灌注情况,对PMD患者的脂肪浸润及水肿肌肉进行定量分析,其中Slow ADC值能反应肌肉脂肪浸润的程度.
展开▼
