摘要：
目的 探讨儿童皮肌炎的磁共振表现及其与临床,特别是肌酶异常的关系.方法 分析临床确诊的50例皮肌炎患儿大腿磁共振图像,了解皮肤、皮下结缔组织、肌筋膜、肌肉受损比例;同时根据磁共振图像中肌肉水肿范围,将患儿分为由轻到重的1、2、3级组,比较各组肌酶水平,了解肌肉损害程度与肌酶升高的相关性.大腿MRI检查序列包括:冠状面及横断面,分别采用快速自旋回波序列FSE T 1 W、抑脂序列STIR.结果 50例皮肌炎患儿中,男26例、女24例,中位年龄4.5(3.0~7.5)岁;肌肉水肿49例,肌筋膜炎28例,皮下结缔组织炎9例,皮肤增厚4例.肌肉水肿1级16例、2级24例、3级9例;肌肉水肿2级组肌酶水平均较另两组高,但仅AST与另两组的差异有统计学意义(P<0.05).结论 磁共振成像易检出皮肌炎肌肉水肿等肌肉损害,有助于判断疾病严重程度及累及范围;皮肌炎患儿肌肉水肿程度与肌酶水平不平行.%Objective To explore the relationship of magnetic resonance imaging (MRI) performance in juvenile dermatomyositis (JDM) with clinical characteristics, especially serum muscle enzyme abnormalities. Methods The images of 50 cases of JDM were reviewed, and the affected skin, subcutaneous connective tissue, muscle fascia and muscle were evaluated. The range of muscle edema under MRI images was categorized into 1-3 grades from mild to complete involvement. By comparing the MRI classification with muscle enzyme, we aim to reveal the linkage between the degree of muscle damage and the levels of muscle enzymes. The sequence of MRI examination of the thigh included rapid spin echo sequence FSE T1W, and the fat suppression sequence STIR in both coronary and axial position. Results In the 50 cases of dermatomyositis, there were 49 cases of muscle edema, 28 cases of myofasciitis, 9 cases of subcutaneous connective tissue inflammation, and 4 cases of thickening skin. Of 49 cases of muscle edema, there are 16 cases in grade 1, 24 in grade 2 and 9 in grade 3. The median value of all muscle enzyme in the grade 2 group was higher than that in the other two groups, and the value of AST was statistically significant, P<0.05. Conclusions The detection rate of JDM using MRI is high, which can help judge the severity and range of involvement. The MRI findings of JDM mainly demonstrated muscle edema, mostly moderate degree, followed by muscular fasciitis.
