TY - JOUR
T1 - Ultrasound and MR muscle imaging in new onset idiopathic inflammatory myopathies at diagnosis and after treatment
T2 - a comparative pilot study
AU - Walter, Anne W.
AU - Lim, Johan
AU - Raaphorst, Joost
AU - Smithuis, Frank F.
AU - den Harder, J. Michiel
AU - Eftimov, Filip
AU - Potters, Wouter
AU - Saris, Christiaan G. J.
AU - de Visser, Marianne
AU - van Schaik, Ivo N.
AU - de Haan, Rob J.
AU - van der Kooi, Anneke J.
AU - Verhamme, Camiel
N1 - Publisher Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology.
PY - 2022/12/23
Y1 - 2022/12/23
N2 - OBJECTIVES: To prospectively compare ultrasound (US) and whole-body MRI for detection of muscle abnormalities compatible with idiopathic inflammatory myopathies (IIM). METHODS: Newly diagnosed IIM patients underwent US (14 muscles) and MRI (36 muscles) at diagnosis and after nine weeks monotherapy with intravenous immunoglobulin. Muscles were compatible with IIM when quantitative US echo-intensity (EI) z scores was ≥1.5, semi-quantitative US Heckmatt score was ≥2, qualitative US was abnormal, or when MRI showed oedema on T2-weighted images. At patient level, findings were classified as abnormal when quantitative US EI z scores was >1.5 (n = 3 muscles), >2.5 (n = 2 muscles) or >3.5 (n = 1 muscle), or if ≥3 muscles showed abnormalities as described above for the other diagnostic methods. RESULTS: At diagnosis, in 18 patients US of 252 muscles revealed abnormalities in 36 muscles (14%) with quantitative, in 153 (61%) with semi-quantitative and in 168 (67%) with qualitative analysis. MRI showed oedema in 476 out of 623 muscles (76%). Five patients (28%) reached abnormal classification with quantitative US, 16 (89%) with semi-quantitative and qualitative US, and all patients (100%) with MRI. Nine-week follow-up of 12 patients showed no change over time with quantitative US or MRI, and a decrease in abnormalities with semi-quantitative US (P <0.01), and qualitative US (P <0.01). CONCLUSION: At diagnosis, MRI was more sensitive than US to detect muscle abnormalities compatible with IIM. Semi-quantitative US and qualitative US detected abnormalities in the majority of the patients while evaluating fewer muscles than MRI and showed change over time after nine weeks of treatment.
AB - OBJECTIVES: To prospectively compare ultrasound (US) and whole-body MRI for detection of muscle abnormalities compatible with idiopathic inflammatory myopathies (IIM). METHODS: Newly diagnosed IIM patients underwent US (14 muscles) and MRI (36 muscles) at diagnosis and after nine weeks monotherapy with intravenous immunoglobulin. Muscles were compatible with IIM when quantitative US echo-intensity (EI) z scores was ≥1.5, semi-quantitative US Heckmatt score was ≥2, qualitative US was abnormal, or when MRI showed oedema on T2-weighted images. At patient level, findings were classified as abnormal when quantitative US EI z scores was >1.5 (n = 3 muscles), >2.5 (n = 2 muscles) or >3.5 (n = 1 muscle), or if ≥3 muscles showed abnormalities as described above for the other diagnostic methods. RESULTS: At diagnosis, in 18 patients US of 252 muscles revealed abnormalities in 36 muscles (14%) with quantitative, in 153 (61%) with semi-quantitative and in 168 (67%) with qualitative analysis. MRI showed oedema in 476 out of 623 muscles (76%). Five patients (28%) reached abnormal classification with quantitative US, 16 (89%) with semi-quantitative and qualitative US, and all patients (100%) with MRI. Nine-week follow-up of 12 patients showed no change over time with quantitative US or MRI, and a decrease in abnormalities with semi-quantitative US (P <0.01), and qualitative US (P <0.01). CONCLUSION: At diagnosis, MRI was more sensitive than US to detect muscle abnormalities compatible with IIM. Semi-quantitative US and qualitative US detected abnormalities in the majority of the patients while evaluating fewer muscles than MRI and showed change over time after nine weeks of treatment.
KW - idiopathic inflammatory myopathy
KW - magnetic resonance imaging
KW - muscle imaging
KW - myositis
KW - ultrasonography
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85144637028&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/35536176
UR - http://www.scopus.com/inward/record.url?scp=85144637028&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/rheumatology/keac263
DO - https://doi.org/10.1093/rheumatology/keac263
M3 - Article
C2 - 35536176
SN - 1462-0324
VL - 62
SP - 300
EP - 309
JO - Rheumatology (Oxford, England)
JF - Rheumatology (Oxford, England)
IS - 1
ER -