背景:在疾病的非常早期阶段诊断可疑的杜兴氏肌营养不良症(DMD)患者具有挑战性。需要更多的证据来证明定量MRI(qMRI)在发生实质性身体衰退之前精确识别患者的潜力。
目的:评估多参数qMRI对DMD患者的早期诊断性能,以及识别轻度功能减退的DMD患者的能力。
方法:前瞻性。
方法:240名DMD受试者(9.0±2.2岁),24名男性健康对照(HCs)(9.2±2.5岁)。
■3.0T/3点Dixon,T1-映射,和T2映射。
结果:qMRI测量(脂肪分数[FF],T1和T2)的11条大腿肌肉(股直肌[RF],股外侧肌[VL],vastusintermedius,中肌,gracilis,Sartorius,长内收肌,内收肌magnus[AM],半腱肌,半膜,股二头肌长头[BFLH])在右侧进行。NorthStar动态评估(NSAA)评分用于评估DMD患者的功能,并将其分为三个亚组:轻度(76-100分),中等(51-75分),和严重(0-50分)功能下降。
方法:独立t检验,方差分析,和接收器工作特性(ROC)曲线。P值<0.05被认为具有统计学意义。
结果:与HC相比,所有DMD患者组的FF和T2均显著增高,而T1则明显降低。T1和T2在RF中的组合,VL,AM,BFLH在区分五名无异常脂肪浸润的DMD患者与HC方面取得了优异的曲线下面积(AUC)(0.967-0.992)。总的来说,T2在区分轻度功能下降的DMD和HC方面达到比FF和T1更高的AUC,而FF在区分三个功能下降的DMD亚组时获得的AUC高于T1和T2。
结论:多参数qMRI在疾病早期对DMD患者具有有效的诊断能力,并能识别轻度体质下降的患者。
方法:2技术效果:阶段3。
BACKGROUND: It is challenging to diagnose suspected Duchenne muscular dystrophy (DMD) patients in the very early stage of the disease. More evidence is needed to demonstrate the potential of quantitative MRI (qMRI) in precisely identifying patients before substantial physical decline occurs.
OBJECTIVE: To assess the early diagnostic performance of multi-parametric qMRI for DMD patients, and the ability to identify DMD patients with mild functional decline.
METHODS: Prospective.
METHODS: One hundred and forty DMD subjects (9.0 ± 2.2 years old), 24 male healthy controls (HCs) (9.2 ± 2.5 years old).
UNASSIGNED: 3.0 T/3-point Dixon, T1-mapping, and T2-mapping.
RESULTS: qMRI measurements (fat fraction [FF], T1, and T2) of 11 thigh muscles (rectus femoris [RF], vastus lateralis [VL], vastus intermedius, vastus medialis, gracilis, sartorius, adductor longus, adductor magnus [AM], semitendinosus, semimembranosus, biceps femoris long head [BFLH]) on the right side were conducted. NorthStar ambulatory assessment (NSAA) score used to evaluate the function of DMD patients and divided them into three subgroups: mild (76-100 score), moderate (51-75 score), and severe (0-50 score) functional decline.
METHODS: Independent t-test, ANOVA analysis, and receiver operating characteristic (ROC) curves. A P-value <0.05 was considered statistically significant.
RESULTS: Compared with HCs, FF and T2 were significantly higher in the group of all DMD patients, while T1 was significantly lower. The combination of T1 and T2 in RF, VL, AM, and BFLH achieved excellent area under curve (AUCs) (0.967-0.992) in differentiating five DMD patients without abnormal fat infiltration from HCs. Overall, T2 reached higher AUCs than FF and T1 in distinguishing DMD with mild functional decline from HCs, whereas FF achieved higher AUCs than T1 and T2 in distinguishing three DMD subgroups with functional decline.
CONCLUSIONS: Multi-parametric qMRI demonstrate effective diagnostic capabilities for DMD patients in the early stage of the disease, and can identify patients with mild physical decline.
METHODS: 2 TECHNICAL EFFICACY: Stage 3.