E E Sigmund1,2,3, S H Baete4,5,6, T Luo4,5, K Patel4,5, D Wang4,5, I Rossi4, A Duarte4, M Bruno4,5,6, D Mossa4,5,6, A Femia7, S Ramachandran7, D Stoffel4,5,6, J S Babb4,5,6,8, A G Franks7,9, J Bencardino4. 1. Department of Radiology, New York University Langone Medical Center, 660 First Ave., New York, NY, 10016, USA. eric.sigmund@nyumc.org. 2. Bernard and Irene Schwartz Center for Biomedical Imaging (CBI), New York University Langone Medical Center, New York, NY, USA. eric.sigmund@nyumc.org. 3. Center for Advanced Imaging and Innovation (CAI2R), New York University Langone Medical Center, New York, NY, USA. eric.sigmund@nyumc.org. 4. Department of Radiology, New York University Langone Medical Center, 660 First Ave., New York, NY, 10016, USA. 5. Bernard and Irene Schwartz Center for Biomedical Imaging (CBI), New York University Langone Medical Center, New York, NY, USA. 6. Center for Advanced Imaging and Innovation (CAI2R), New York University Langone Medical Center, New York, NY, USA. 7. Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, NY, USA. 8. Division of Biostatistics, New York University Langone Medical Center, New York, NY, USA. 9. Department of Medicine, Division of Rheumatology, New York University Langone Medical Center, New York, NY, USA.
Abstract
INTRODUCTION: Dermatomyositis (DM) is an idiopathic inflammatory myopathy involving severe debilitation in need of diagnostics. We evaluated the proximal lower extremity musculature with diffusion tensor imaging (DTI), intravoxel incoherent motion (IVIM) and dynamic DTI in DM patients and controls and compared with standard clinical workup. METHODS: In this IRB-approved, HIPAA-compliant study with written informed consent, anatomical, Dixon fat/water and diffusion imaging were collected in bilateral thigh MRI of 22 controls and 27 DM patients in a 3T scanner. Compartments were scored on T1/T2 scales. Single voxel dynamic DTI metrics in quadriceps before and after 3-min leg exercise were measured. Spearman rank correlation and mixed model analysis of variance/covariance (ANOVA/ANCOVA) were used to correlate with T1 and T2 scores and to compare patients with controls. RESULTS: DM patients showed significantly lower pseudo-diffusion and volume in quadriceps than controls. All subjects showed significant correlation between T1 score and signal-weighted fat fraction; tissue diffusion and pseudo-diffusion varied significantly with T1 and T2 score in patients. Radial and mean diffusion exercise response in patients was significantly higher than controls. CONCLUSION: Static and dynamic diffusion imaging metrics show correlation with conventional imaging scores, reveal spatial heterogeneity, and provide means to differentiate dermatomyositis patients from controls. KEY POINTS: • Diffusion imaging shows regional differences between thigh muscles of dermatomyositis patients and controls. • Signal-weighted fat fraction and diffusion metrics correlate with T1/T2 scores of disease severity. • Dermatomyositis patients show significantly higher radial diffusion exercise response than controls.
INTRODUCTION:Dermatomyositis (DM) is an idiopathic inflammatory myopathy involving severe debilitation in need of diagnostics. We evaluated the proximal lower extremity musculature with diffusion tensor imaging (DTI), intravoxel incoherent motion (IVIM) and dynamic DTI in DMpatients and controls and compared with standard clinical workup. METHODS: In this IRB-approved, HIPAA-compliant study with written informed consent, anatomical, Dixon fat/water and diffusion imaging were collected in bilateral thigh MRI of 22 controls and 27 DMpatients in a 3T scanner. Compartments were scored on T1/T2 scales. Single voxel dynamic DTI metrics in quadriceps before and after 3-min leg exercise were measured. Spearman rank correlation and mixed model analysis of variance/covariance (ANOVA/ANCOVA) were used to correlate with T1 and T2 scores and to compare patients with controls. RESULTS:DMpatients showed significantly lower pseudo-diffusion and volume in quadriceps than controls. All subjects showed significant correlation between T1 score and signal-weighted fat fraction; tissue diffusion and pseudo-diffusion varied significantly with T1 and T2 score in patients. Radial and mean diffusion exercise response in patients was significantly higher than controls. CONCLUSION: Static and dynamic diffusion imaging metrics show correlation with conventional imaging scores, reveal spatial heterogeneity, and provide means to differentiate dermatomyositispatients from controls. KEY POINTS: • Diffusion imaging shows regional differences between thigh muscles of dermatomyositispatients and controls. • Signal-weighted fat fraction and diffusion metrics correlate with T1/T2 scores of disease severity. • Dermatomyositispatients show significantly higher radial diffusion exercise response than controls.
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