这篇综述说明了横纹肌溶解在多种模式和各种临床情况下的影像学特征。横纹肌溶解症是横纹肌在严重或长期损伤后迅速分解,导致肌细胞成分释放到循环中。反过来,患者出现特征性血清肌酸激酶升高,尿肌红蛋白阳性,以及其他血清和尿液实验室紊乱。虽然有一系列临床症状,经典的演讲被描述为肌肉疼痛,弱点,和深色尿液。这个三合会,然而,仅在大约10%的患者中看到。因此,当临床高度怀疑时,成像在评估肌肉受累程度方面是有价值的,随后的并发症,如肌坏死和肌肉萎缩,和其他病因或并发损伤导致肌肉骨骼肿胀和疼痛,尤其是在创伤的背景下。横纹肌溶解的后遗症可能是肢体或危及生命,包括室综合征,肾功能衰竭,和弥散性血管内凝血。MRI,CT,超声,和18-FDGPET/CT是评估横纹肌溶解的有用方法。
This
review illustrates the imaging features of rhabdomyolysis across multiple modalities and in a variety of clinical scenarios. Rhabdomyolysis is the rapid breakdown of striated muscle following severe or prolonged insult resulting in the release of myocyte constituents into circulation. In turn, patients develop characteristically elevated serum creatine kinase, positive urine myoglobin, and other serum and urine laboratory derangements. While there is a spectrum of clinical symptoms, the classic presentation has been described as muscular pain, weakness, and dark urine. This triad, however, is only seen in about 10% of patients. Thus, when there is a high clinical suspicion, imaging can be valuable in evaluating the extent of muscular involvement, subsequent complications such as
myonecrosis and muscular atrophy, and other etiologies or concurrent injuries causing musculoskeletal swelling and pain, especially in the setting of trauma. Sequela of rhabdomyolysis can be limb or life-threatening including compartment syndrome, renal failure, and disseminated intravascular coagulation. MRI, CT, ultrasound, and 18-FDG PET/CT are useful modalities in the evaluation of rhabdomyolysis.