MRI in the study of distal primary myopathopies and of muscular alterations due to peripheral neuropathies: possible diagnostic capacities of MR equipment with low intensity field (0.2 T) dedicated to peripheral limbs.
The purpose of this work was to investigate whether or not an magnetic resonance imaging (MRI) equipment with a low field intensity (0.2 T) used in the study of muscular alterations can diagnose primary or secondary myopathies, due to peripheral neuropathies. In this study the peripheral areas of all patients were examined. A total of 40 patients (23 males and 17 females) were tested. Their age ranged from 10 to 78 years age (mean age 40.8, SD +/- 19,45 years). The group includes 23 patients: 18 with Stainert Myotonic Distrophy, 5 were myositic, and the remaining 17 had peropheral neuropathies. Every patient received a clinic examination, followed by EMG and MRI. The MRI study was done with a system dedicated to the study of limbs (Artoscan, Esaote Biomedica) that used a 0.2 T permanent magnet. Spin-echo T1, T2-weighted, multiple-echo, and STIR sequences were used. A good correspondence was found between clinical and MRI data. Specifically, in the group of 23 myopathies, Sperman's index was found to be 0.80 in its correlation between the clinical examination and MRI; in the group of 17 myopathies it was found to be 0.63. A discrepancy was found among clinical examination, EMG, and MRI in patients with neuropathies who were showing a lack of myelin and mixed ones. The T2-weighted and STIR sequences had great sensitivity in showing initial changes in the muscles. The SE T1-weighted sequence was especially useful in detecting degeneration in the fibrous adipose tissue. The STIR sequence because of its high sensitivity and greater speed of response could be used instead of the SE T2 weighted particularly in the study of patients, who were noted to tolerate a prolonge period of scanning. However, because these sequences have a low signal noise ratio, they must always be associated with a SE sequence, whenever there would be need of a precise determination of the structures under study. The MRI low field intensity was also found to be a useful technique in screening familial groups having a great number of myotonic distrophies. It can have a great clinical role in revealing muscular alterations, even in asymptomatic patients.
Messineo
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Dipartmento di Medicina Sperimentale e Patologia, I Cattedra di Radiologia, Universita di Roma La Sapienza, Rome, Italy. mesdan@flashnet.it
Cremona
A
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Trinci
M
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Francia
A
A
Marini
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A
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003937:Diagnosis, Differential; D004576:Electromyography; D005260:Female; D005542:Forearm; D006801:Humans; D007866:Leg; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation / Q000473:pathology* / Q000503:physiopathology; D009220:Myositis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D009223:Myotonic Dystrophy / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000175:diagnosis; D012680:Sensitivity and Specificity