title: Pathologic skeletal muscle perfusion in patients with myositis: detection with quantitative contrast-enhanced US--initial results.
abstract: OBJECTIVE
  To prospectively determine whether contrast material-enhanced ultrasonography (US) can depict inflammation-induced changes in muscle perfusion for patients suspected of having dermatomyositis or polymyositis and to compare these findings with those of magnetic resonance (MR) imaging and muscle biopsy.
  
  
  METHODS
  Institutional review board approval and informed consent were obtained. Perfusion in skeletal muscles was quantified with contrast-enhanced intermittent power Doppler US by applying a modified model that analyzed the replenishment kinetics of microbubbles. In 22 patients (16 women, six men; mean age, 52 years +/- 17) who were suspected of having myositis and in 10 healthy volunteers (two women, eight men; mean age, 28 years +/- 4), contrast-enhanced US of the clinically affected right biceps muscle was performed to measure blood flow, blood volume, and blood flow velocity. Additionally, the right upper arm was examined with a 1.5-T unit by using three different MR imaging techniques. Findings were compared with the results of clinical examinations and muscle biopsy. Data for perfusion-related parameters obtained at contrast-enhanced US were analyzed by using a nonparametric Mann-Whitney U test.
  
  
  RESULTS
  Eight patients had histologically confirmed myositis and showed significantly higher blood flow velocity (P = .01), blood flow (P = .001), and blood volume (P = .002) at contrast-enhanced US than did patients who did not have myositis. Blood flow velocity (P = .001) and blood flow (P = .002) were significantly higher in patients with myositis than in volunteers. An increase in signal intensity on T2-weighted MR images was found in all patients with myositis, while contrast material enhancement on fat-suppressed T1-weighted MR images was found in only four of seven patients with myositis.
  
  
  CONCLUSIONS
  Initial results show that contrast-enhanced US is a feasible method for noninvasively demonstrating increased perfusion in the involved muscle groups in patients with myositis.
authors.affiliation: Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany. m.a.weber@dkfz.de
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Weber
authors.forename: Martin
authors.initials: M
authors.lastname: Krix
authors.forename: Uta
authors.initials: U
authors.lastname: Jappe
authors.forename: Hagen B
authors.initials: HB
authors.lastname: Huttner
authors.forename: Marius
authors.initials: M
authors.lastname: Hartmann
authors.forename: Uta
authors.initials: U
authors.lastname: Meyding-Lamadé
authors.forename: Marco
authors.initials: M
authors.lastname: Essig
authors.forename: Christoph
authors.initials: C
authors.lastname: Fiehn
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Kauczor
authors.forename: Stefan
authors.initials: S
authors.lastname: Delorme
mesh_terms: D001706:Biopsy; D003287:Contrast Media; D003882:Dermatomyositis / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*; D017285:Polymyositis / Q000000981:diagnostic imaging* / Q000473:pathology*; D011446:Prospective Studies; D012039:Regional Blood Flow; D014463:Ultrasonography
chemical_list: D003287:Contrast Media