Whole-body MR imaging in evaluation of children with juvenile dermatomyositis. Issue 155 (October 2022)

• Record Type: Journal Article
• Authors: Sreelal TV, ; Bhatia, Anmol; Suri, Deepti; Singh, Surjit; Saxena, Akshay K.; Tao, Ting Y.; Sodhi, Kushaljit Singh
• Is Part Of: European journal of radiology. Issue 155(2022)
• Publication Date: 2022-10
• Subjects: Juvenile dermatomyositis -- MRI -- Whole-body MRI -- Children -- Inflammatory myopathies; ALT Alanine aminotransferase -- ANA Antinuclear antibody -- AST Aspartate aminotransferase -- CKNAC Creatine kinase (N-acetyl cysteine) -- CRP C-reactive protein -- DWI Diffusion-weighted imaging -- EMG Electromyography -- ESR Erythrocyte sedimentation rate -- EULAR/ACR European League Against Rheumatism/American College of Rheumatology -- JDM Juvenile dermatomyositis -- LDH Lactic dehydrogenase -- MRI Magnetic resonance imaging -- STIR Short tau inversion recovery -- WBMRI Whole-body MRI; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2022.110475
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Whole-body MRI (WBMRI) helps to assess the disease (extent and distribution) in children with juvenile dermatomyositis (JDM). Abnormal STIR signal and diffusion restriction on WBMRI are useful for the evaluation of myositis in children with JDM. The addition of contrast sequences does not provide any significant additional benefit in detecting muscle involvement. Abstract: Purpose: To evaluate the whole-body MRI (WBMRI) findings in children with juvenile dermatomyositis (JDM) and correlate them with clinical and laboratory results. Method: We conducted the present prospective study from October 2019 to September 2021. Thirty children (8.2 ± 3.88 years) with a diagnosis of JDM based on EULAR/ACR classification criteria underwent WBMRI using short tau inversion recovery, diffusion-weighted, and T1 modified DIXON (precontrast and postcontrast) sequences. WBMRI scans were analysed independently by two radiologists for abnormal signal intensity and enhancement in the different muscle groups. Radiological findings were correlated with clinical examination, muscle enzymes, and inflammatory markers. Results: WBMRI revealed abnormal signal intensity and diffusion restriction, predominantly in the thigh (n = 21, 70 % children), calf (n = 18, 60 % children), and hip (n = 16, 53.3 % children) muscles. A significant positive correlation was observed between the serum total creatinine kinase and lactic dehydrogenase levels, with altered signal intensity and diffusion restriction in the paraspinal and thigh muscles. Diffusion restriction in the hip and calf muscles also showed significant positive correlations with these enzymes. Significant positive correlations were detected between lower limb muscle strength and altered signal intensity and diffusion restriction in the thigh (p = 0.023) and calf (p = 0.002) muscles. Postcontrast images did not yield any additional useful information. Conclusions: WBMRI provided useful information in evaluation of the extent and distribution of findings in children with JDM. There were significant positive correlations between MRI findings and muscle enzymes and clinical examination results. The addition of contrast to the WBMRI protocol did not provide any additional advantage.