학술논문
Magnetic resonance imaging scoring system of the lower limbs in adult patients with suspected idiopathic inflammatory myopathy
Document Type
Original Paper
Author
Gramegna, Laura Ludovica; Rinaldi, Rita; Belotti, Laura Maria Beatrice; Vignatelli, Luca; Sighinolfi, Giovanni; Papa, Valentina; Costa, Roberta; D’Angelo, Roberto; Bianchini, Claudio; Graziano, Claudio; Cirignotta, Lorenzo; Mule, Rita; Manners, David Neil; Tonon, Caterina; Cenacchi, Giovanna; Lodi, Raffaele
Source
Neurological Sciences. 45(7):3461-3470
Subject
Language
English
ISSN
1590-1874
1590-3478
1590-3478
Abstract
Abstract : Purpose: We aim to propose a visual quantitative score for muscle edema in lower limb MRI to contribute to the diagnosis of idiopathic inflammatory myopathy (IIM).Material and methods: We retrospectively evaluated 85 consecutive patients (mean age 57.4 ± 13.9 years; 56.5% female) with suspected IIM (muscle weakness and/or persistent hyper-CPK-emia with/without myalgia) who underwent MRI of lower limbs using T2-weighted fast recovery-fast spin echo images and fat-sat T2 echo planar images. Muscle inflammation was evaluated bilaterally in 11 muscles of the thigh and eight muscles of the leg. Edema in each muscle was graded according to a four-point Likert-type scale adding up to 114 points ([11 + 8)] × 3 × 2). Diagnostic accuracy of the total edema score was explored by assessing sensitivity and specificity using the area under the ROC curve. Final diagnoses were made by a multidisciplinary Expert Consensus Panel applying the Bohan and Peter diagnostic criteria whenever possible.Results: Of the 85 included patients, 34 (40%) received a final diagnosis of IIM (IIM group) while 51 (60%) received an alternative diagnosis (non-IIM group). A cutoff score ≥ 18 was able to correctly classify patients having an IIM with an area under the curve of 0.85, specificity of 96%, and sensitivity of 52.9%.Conclusion: Our study demonstrates that a quantitative MRI score for muscle edema in the lower limbs (thighs and legs) aids in distinguishing IIM from conditions that mimic it.