Duchenne肌营养不良患者大腿肌肉水肿分析:基于MRIOA

Objective To investigate the severity of muscle edema in the bilateral thighs of patients with Duchenne muscular dystrophy(DMD)using conventional MRI and diffusion-weighted imaging(DWI)sequences and to analyze their correlations.Methods The bilateral thigh MRI data of 63 genetically confirmed DMD patients from Northwest Women's and Children's Hospital(collected between January 2023 and December 2024)were retrospectively analyzed.The patients were divided into three age groups:toddler group(<3 years old,n=6),preschool group(3-5 years old,n=36),and school-age group(6-12 years old,n=21).Statistical analysis was performed to examine the associations between edema distribution across 11 bilateral thigh muscles and the following factors:DWI hyperintensity,fatty infiltration,and age grouping.Results Among the 63 patients,the muscles with higher incidence of edema were the vastus medialis(right:47 cases,left:44 cases)and the long head of the biceps femoris(right:37 cases,left:52 cases),while the muscles with lower incidence were the semitendinosus(right:14 cases,left:16 cases)and the gracilis(right:17 cases,left:16 cases).Regarding edema scores,the vastus medialis(right:82 points,left:69 points)and the long head of the biceps femoris(right:60 points,left:84 points)had higher scores,whereas the semitendinosus(right:17 points,left:23 points)and the gracilis(right:24 points,left:22 points)had lower scores.The 11 muscles were anatomically divided into three muscle groups:the anterior group(rectus femoris,vastus lateralis,vastus medialis,vastus intermedius,sartorius),the medial group(adductor longus,adductor magnus,gracilis),and the posterior group(semimembranosus,semitendinosus,long head of the biceps femoris).The proportion of muscle edema in the medial group of both legs showed a negative correlation with increasing age(right:r=-0.407,P<0.01;left:r=-0.278,P=0.027),while no correlation was found between the proportion of muscle edema in the anterior or posterior groups and increasing age in either leg(P>0.05).Muscle edema in both legs was correlated with DWI hyperintensity(P<0.01),with the highest correlation observed in the left adductor magnus(r=0.929,P<0.01)and the lowest in the right semimembranosus(r=0.651,P<0.01).No correlation was found between edema and fatty infiltration in any of the 11 muscles of both legs.Conclusion MRI can semi-quantitatively display the distribution and severity of muscle edema in the bilateral thighs of DMD patients.Among these,the proportion of edema in the medial muscle group shows a decreasing trend with increasing age.There is a high correlation between DWI hyperintensity and the distribution of muscle edema,with the strongest correlation observed in the left adductor magnus.