Shivani Ahlawat1, Julie Paik2, Filippo Del Grande3,4, Elias S Paris5, Parvinder Sujlana5, Laura M Fayad5. 1. The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA. sahlawa1@jhmi.edu. 2. Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 3. University of Zurich, Raemistrasse 71, 8006, Zurich, Switzerland. 4. Department of Radiology, Ospedale Regionale Di Lugano, Via Tesserete 46, 6900, Lugano, Switzerland. 5. The Russell H. Morgan Department of Radiology & Radiological Science, The Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
Abstract
OBJECTIVE: To compare the MRI features in patients with fibrosing [FM] versus non-fibrosing [NFM] systemic sclerosis [SSc]-associated myopathy. METHODS: 10 patients with FM and 14 with NFM underwent bilateral thigh MRI [T1-weighted, STIR and DW/ADC mapping]. Three observers, blinded to histology evaluated 36 muscles per patient for presence of intramuscular edema, fascial edema, fatty replacement and atrophy and measured ADC values. Fisher's exact test and student's t-test were used to compare MRI findings of FM [endomysial/ perimysial fibrosis] and NFM [necrosis/inflammation] on histology. RESULTS: Intramuscular edema [p < 0.0001] and fascial edema [p = 0.07] were more common in FM. On DWI, elevated intramuscular signal was more common in FM, [low b-value: p < 0.0001 and high b-value: p < 0.0001]. On T1, NFM exhibited more fatty replacement [p = < 0.0001] and atrophy [p = < 0.0001]. CONCLUSIONS: Intramuscular and fascial edema on MRI are more common in SSc-associated FM, while markers of chronic muscle damage are more often associated with NFM.
OBJECTIVE: To compare the MRI features in patients with fibrosing [FM] versus non-fibrosing [NFM] systemic sclerosis [SSc]-associated myopathy. METHODS: 10 patients with FM and 14 with NFM underwent bilateral thigh MRI [T1-weighted, STIR and DW/ADC mapping]. Three observers, blinded to histology evaluated 36 muscles per patient for presence of intramuscular edema, fascial edema, fatty replacement and atrophy and measured ADC values. Fisher's exact test and student's t-test were used to compare MRI findings of FM [endomysial/ perimysial fibrosis] and NFM [necrosis/inflammation] on histology. RESULTS: Intramuscular edema [p < 0.0001] and fascial edema [p = 0.07] were more common in FM. On DWI, elevated intramuscular signal was more common in FM, [low b-value: p < 0.0001 and high b-value: p < 0.0001]. On T1, NFM exhibited more fatty replacement [p = < 0.0001] and atrophy [p = < 0.0001]. CONCLUSIONS: Intramuscular and fascial edema on MRI are more common in SSc-associated FM, while markers of chronic muscle damage are more often associated with NFM.
Entities:
Keywords:
Diffusion weighted imaging; Fibrosis; Magnetic resonance imaging; Myopathy; Scleroderma