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Comparative Study
. 2019 Jul-Aug;37(4):633-640.
Epub 2018 Dec 19.

Correlation between quantitative and semiquantitative magnetic resonance imaging and histopathology findings in dermatomyositis

José César Milisenda  1 , María Victoria Collado  2 , Iago Pinal-Fernandez  3 , Andres Hormaza Jaramillo  4 , Marie Faruch Bilfeld  5 , María Dolores Cano  6 , Ana Isabel García  7 , Xavier Tomás  8 , Josep María Grau  9
Affiliations
Comparative Study

Correlation between quantitative and semiquantitative magnetic resonance imaging and histopathology findings in dermatomyositis

José César Milisenda et al. Clin Exp Rheumatol. 2019 Jul-Aug.

Abstract

Objectives: The aim of this study was to compare muscle biopsy findings, as well as clinical and analytical features, with those of magnetic resonance imaging (MRI) studies of muscle in patients with dermatomyositis.

Methods: All patients from the Longitudinal Myopathy Cohort of the Hospital Clínic de Barcelona were prospectively included in the study from 2009 to 2016. MRI images of muscle and fascial oedema were compared with muscle pathology results using both quantitative and semi-quantitative scores.

Results: We found a statistically significant association between the inflammatory infiltrate and both muscle (r2=0.54, p=0.001) and fascial oedema (r2=0.54, p<0.001). In addition, muscle oedema was significantly associated with punched-out vacuoles (p=0.04) and muscle enzymes in serum (r2=0.34, p=<0.01 for CK and r2=0.22, p<0.05 for aldolase). The number of treatment drugs received at the time of MRI was inversely associated with the number of muscle inflammatory cells in the biopsy and with both muscle and fascial oedema (all p<0.05).

Conclusions: Key MRI findings correlate with the main features of dermatomyositis muscle biopsy results, suggesting that MRI findings could be used as a surrogate marker of disease activity.

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Conflict of interest statement

Competing interests: none declared.

Figures

Fig. 1.
Fig. 1.
MRI evaluation. A-B-C) Axial STIR images of the vastus lateralis and deltoid muscles. Quantitative measurement of ME and FE in two selected MRI images. Green (muscle area), yellow (fascial area).
Fig. 2.
Fig. 2.
MRI evaluation. Semi-quantitative analysis of four regions: 1. scapular girdle and arms 2. chest and abdomen 3. pelvic girdle 4. thigh
Fig. 3.
Fig. 3.
Statistical analysis of MRI, clinical and muscle biopsy features.
Fig. 4.
Fig. 4.
Statistical analysis of MRI, clinical and muscle biopsy features.
Fig. 5.
Fig. 5.
Muscle biopsies with the corresponding MRI (STIR) images. A: patient n° 3, B: patient n° 11 C: patient n° 8. A-B-C: Cross-sectional H&E stained muscle-biopsy samples with classic DM perifascicular atrophy (stars) and inflammatory infiltrate (circles). A: Biceps muscle (arrow) ME 6.29 and FE 10.33. B: Deltoid muscle (arrow) ME 13.69 and FE 16.07. C: Deltoid muscle (arrow) ME 39.20 and FE 36.9.
See this image and copyright information in PMC

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