皮肌炎影像学诊断

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1、My-LinhNguyen,HMSIIIGillianLieberman,MDJune22,2009Agenda•Ourpatient•Dermatomyositisfacts–Epidemiology–Diagnosis•Radiologyindermatomyositis–Menuoftests–Classicfindings–Anemergingroleforradiology•SummaryOurpatient:history(part1)•11year-oldmalepresentswithmuscleweakn

2、ess.ClinicianrequestsalowerextremityMRI.CasecourtesyofDr.DianaFerrisOurpatient:coronalthighT1-weightedMRIAnalyzefor:•Anatomicabnormalities•Fatinfiltrationofmuscles•MuscleatrophyorhypertrophyThisT1-weightedMRIisnormal.Thereisnomuscleatrophyorfatinfiltration.Imageco

3、urtesyofDr.DianaFerrisOurpatient:coronalthighT1-weightedMRIAnalyzefor:•Anatomicabnormalities•Fatinfiltrationofmuscles•MuscleatrophyorhypertrophyThisT1-weightedMRIisnormal.Thereisnomuscleatrophyorfatinfiltration.ImagecourtesyofDr.DianaFerrisCourtesyofDr.DianaFerris

4、Ourpatient:coronalthighT2-weightedMRIAnalyzefor:1.Muscleedema2.FocalareasofincreasedintensityThisMRIdemonstratesdiffusehyperintensesignalinthighmusclesbilaterally.Nofocallesionsareseen.Findingsareconsistentwithbilateral,symmetricmuscleedema.CourtesyofDr.DianaFerri

5、sOurpatient:coronalthighT2-weightedMRIAnalyzefor:1.Muscleedema2.FocalareasofincreasedintensityThisMRIdemonstratesdiffusehyperintensesignalinthighmusclesbilaterally.Nofocallesionsareseen.Findingsareconsistentwithbilateral,symmetricmuscleedema.Differentialformusclee

6、dema1•Trauma•Necrosis•Intramuscularhemorrhage•Tumor•Myositis•Earlystagedenervation•Radiation•Overuse1VahlensiekM,etal.MRIoftheMusculoskeletalSystem.NewYork:Thieme,1999.Differentialformuscleedema1•TraumaÆnohistory•Necrosis•Intramuscularhemorrhage•Tumor•Myositis•Ear

7、lystagedenervation•RadiationÆnohistory•OveruseÆnohistory1VahlensiekM,etal.MRIoftheMusculoskeletalSystem.NewYork:Thieme,1999.Differentialformuscleedema1•TraumaÆnohistory•NecrosisÆmorelikelyiffocal•IntramuscularhemorrhageÆfocal•TumorÆfocal•Myositis•Earlystagedenerva

8、tion•RadiationÆnohistory•OveruseÆnohistory1VahlensiekM,etal.MRIoftheMusculoskeletalSystem.NewYork:Thieme,1999.Differentialformuscleedema1•TraumaÆnohisto