title: Contrast-enhanced ultrasound in dermatomyositis- and polymyositis.
abstract: OBJECTIVE
  To evaluate prospectively contrast-enhanced ultrasound (CEUS) in patients suspected of having dermatomyositis or polymyositis.
  
  
  METHODS
  In 35 patients (23 women, 12 men; mean age, 51 years+/-16 years) who were suspected of having dermatomyositis or polymyositis, perfusion in clinically affected skeletal muscles was quantified with contrast-enhanced intermittent power Doppler ultrasound. By applying a modified model that analyzed the replenishment kinetics of microbubbles, the perfusion-related parameters blood flow, local blood volume and blood flow velocity were measured. Findings were compared with muscle biopsy appearances and with the results of MRI that was performed with a 1.5-Tesla unit. Receiver operating characteristic analysis was performed and optimum thresholds for diagnosis of myositis were determined.
  
  
  RESULTS
  Eleven patients had histologically confirmed dermatomyositis or polymyositis and showed significantly higher blood flow velocity (P=.01 for dermato- and P<.001 for polymyositis), blood flow (P<.001 for dermato- and polymyositis), and blood volume (P=.007 for dermato- and P<.001 for polymyositis) on contrast-enhanced ultrasound than those who did not have myositis. An increase in signal intensity on T2-weighted MR images was found in all patients with myositis. MRI had a sensitivity, specificity, positive (PPV), and negative predicting values (NPV) of 100%, 88%, 77%, and 100% for diagnosis of myositis, respectively. CEUS blood flow was the best ultrasound measure for diagnosis of dermato- or polymyositis with sensitivity, specificity, PPV, and NPV of 73%, 91%, 80%, and 88%, respectively.
  
  
  CONCLUSIONS
  Increased skeletal muscle perfusion measured by CEUS could serve as an additional measurer for the diagnosis of an inflammatory myopathy.
authors.affiliation: m.a.weber@dkfz.de
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Weber
authors.forename: Uta
authors.initials: U
authors.lastname: Jappe
authors.forename: Marco
authors.initials: M
authors.lastname: Essig
authors.forename: Martin
authors.initials: M
authors.lastname: Krix
authors.forename: Carina
authors.initials: C
authors.lastname: Ittrich
authors.forename: Hagen B
authors.initials: HB
authors.lastname: Huttner
authors.forename: B Hagen
authors.initials: BH
authors.lastname: Huttner
authors.forename: Uta
authors.initials: U
authors.lastname: Meyding-Lamadé
authors.forename: Marius
authors.initials: M
authors.lastname: Hartmann
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Kauczor
authors.forename: Stefan
authors.initials: S
authors.lastname: Delorme
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D003882:Dermatomyositis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D017285:Polymyositis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000379:methods*