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Quantitative assessment of the T2 relaxation time of the gluteus muscles in children with Duchenne muscular dystrophy: a comparative study before and after steroid treatment.

Kim HK, Laor T, Horn PS, Wong B - Korean J Radiol (2010)

Bottom Line: None of the patients showed interval change of their CFSs.Of these, three showed an increased mean T2 relaxation time (p < 0.05), two showed no change and four showed a decreased mean T2 relaxation time (p < 0.05).The differences of the mean T2 relaxation time may reflect alterations in disease activity, and even when the conventional MRI and CFS remain stable.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA. Hee.Kim@cchmc.org

ABSTRACT

Objective: To determine the feasibility of using T2 mapping as a quantitative method to longitudinally follow the disease activity in children with Duchenne muscular dystrophy (DMD) who are treated with steroids.

Materials and methods: ELEVEN BOYS WITH DMD (AGE RANGE: 5-14 years) underwent evaluation with the clinical functional score (CFS), and conventional pelvic MRI and T2 mapping before and during steroid therapy. The gluteus muscle inflammation and fatty infiltration were evaluated on conventional MRI. The histograms and mean T2 relaxation times were obtained from the T2 maps. The CFS, the conventional MRI findings and the T2 values were compared before and during steroid therapy.

Results: None of the patients showed interval change of their CFSs. On conventional MRI, none of the images showed muscle inflammation. During steroid treatment, two boys showed increased fatty infiltration on conventional MRI, and both had an increase of the mean T2 relaxation time (p < 0.05). The remaining nine boys had no increase in fatty infiltration. Of these, three showed an increased mean T2 relaxation time (p < 0.05), two showed no change and four showed a decreased mean T2 relaxation time (p < 0.05).

Conclusion: T2 mapping is a feasible technique to evaluate the longitudinal muscle changes in those children who receive steroid therapy for DMD. The differences of the mean T2 relaxation time may reflect alterations in disease activity, and even when the conventional MRI and CFS remain stable.

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5-year-old boy with Duchenne muscular dystrophy. Conventional MRI and T2 maps obtained prior to and during 16-month course of steroid therapy.A. Axial T1 weighted image (TR/TE 600/23) shows very minimal fatty infiltration within gluteus maximus muscle. Clinical function score was assessed as 1 (normal).B. Follow-up axial T1 weighted image (TR/TE 517/14) shows no significant interval change of fatty infiltration within gluteus maximus muscle. Clinical functional score was assessed as 1 (normal).C, D. Color coded T2 map shows color change from higher scale color (red) (C) to lower scale color (yellow) within gluteal muscles (D).E. Histogram demonstrates statistically significant different distribution between two time points. Mean T2 value for this patient decreased (from 62.1 msec on initial study to 57.4 msec on follow-up study).
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Figure 5: 5-year-old boy with Duchenne muscular dystrophy. Conventional MRI and T2 maps obtained prior to and during 16-month course of steroid therapy.A. Axial T1 weighted image (TR/TE 600/23) shows very minimal fatty infiltration within gluteus maximus muscle. Clinical function score was assessed as 1 (normal).B. Follow-up axial T1 weighted image (TR/TE 517/14) shows no significant interval change of fatty infiltration within gluteus maximus muscle. Clinical functional score was assessed as 1 (normal).C, D. Color coded T2 map shows color change from higher scale color (red) (C) to lower scale color (yellow) within gluteal muscles (D).E. Histogram demonstrates statistically significant different distribution between two time points. Mean T2 value for this patient decreased (from 62.1 msec on initial study to 57.4 msec on follow-up study).

Mentions: The T2 maps from the remaining nine boys who showed no change of muscle signal on conventional MRI showed different distribution patterns on the histograms. Three of the nine boys showed a statistically significant rightward shift of the histograms (P < 0.05) between the initial and the follow-up examinations (Fig. 3). Two of the nine boys showed no statistically significant different distribution of the histograms (Fig. 4). The remaining four boys showed a statistically significant leftward shift of the histograms (P < 0.05) with a decrease of the mean T2 relaxation time (Fig. 5).


Quantitative assessment of the T2 relaxation time of the gluteus muscles in children with Duchenne muscular dystrophy: a comparative study before and after steroid treatment.

Kim HK, Laor T, Horn PS, Wong B - Korean J Radiol (2010)

5-year-old boy with Duchenne muscular dystrophy. Conventional MRI and T2 maps obtained prior to and during 16-month course of steroid therapy.A. Axial T1 weighted image (TR/TE 600/23) shows very minimal fatty infiltration within gluteus maximus muscle. Clinical function score was assessed as 1 (normal).B. Follow-up axial T1 weighted image (TR/TE 517/14) shows no significant interval change of fatty infiltration within gluteus maximus muscle. Clinical functional score was assessed as 1 (normal).C, D. Color coded T2 map shows color change from higher scale color (red) (C) to lower scale color (yellow) within gluteal muscles (D).E. Histogram demonstrates statistically significant different distribution between two time points. Mean T2 value for this patient decreased (from 62.1 msec on initial study to 57.4 msec on follow-up study).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2864857&req=5

Figure 5: 5-year-old boy with Duchenne muscular dystrophy. Conventional MRI and T2 maps obtained prior to and during 16-month course of steroid therapy.A. Axial T1 weighted image (TR/TE 600/23) shows very minimal fatty infiltration within gluteus maximus muscle. Clinical function score was assessed as 1 (normal).B. Follow-up axial T1 weighted image (TR/TE 517/14) shows no significant interval change of fatty infiltration within gluteus maximus muscle. Clinical functional score was assessed as 1 (normal).C, D. Color coded T2 map shows color change from higher scale color (red) (C) to lower scale color (yellow) within gluteal muscles (D).E. Histogram demonstrates statistically significant different distribution between two time points. Mean T2 value for this patient decreased (from 62.1 msec on initial study to 57.4 msec on follow-up study).
Mentions: The T2 maps from the remaining nine boys who showed no change of muscle signal on conventional MRI showed different distribution patterns on the histograms. Three of the nine boys showed a statistically significant rightward shift of the histograms (P < 0.05) between the initial and the follow-up examinations (Fig. 3). Two of the nine boys showed no statistically significant different distribution of the histograms (Fig. 4). The remaining four boys showed a statistically significant leftward shift of the histograms (P < 0.05) with a decrease of the mean T2 relaxation time (Fig. 5).

Bottom Line: None of the patients showed interval change of their CFSs.Of these, three showed an increased mean T2 relaxation time (p < 0.05), two showed no change and four showed a decreased mean T2 relaxation time (p < 0.05).The differences of the mean T2 relaxation time may reflect alterations in disease activity, and even when the conventional MRI and CFS remain stable.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA. Hee.Kim@cchmc.org

ABSTRACT

Objective: To determine the feasibility of using T2 mapping as a quantitative method to longitudinally follow the disease activity in children with Duchenne muscular dystrophy (DMD) who are treated with steroids.

Materials and methods: ELEVEN BOYS WITH DMD (AGE RANGE: 5-14 years) underwent evaluation with the clinical functional score (CFS), and conventional pelvic MRI and T2 mapping before and during steroid therapy. The gluteus muscle inflammation and fatty infiltration were evaluated on conventional MRI. The histograms and mean T2 relaxation times were obtained from the T2 maps. The CFS, the conventional MRI findings and the T2 values were compared before and during steroid therapy.

Results: None of the patients showed interval change of their CFSs. On conventional MRI, none of the images showed muscle inflammation. During steroid treatment, two boys showed increased fatty infiltration on conventional MRI, and both had an increase of the mean T2 relaxation time (p < 0.05). The remaining nine boys had no increase in fatty infiltration. Of these, three showed an increased mean T2 relaxation time (p < 0.05), two showed no change and four showed a decreased mean T2 relaxation time (p < 0.05).

Conclusion: T2 mapping is a feasible technique to evaluate the longitudinal muscle changes in those children who receive steroid therapy for DMD. The differences of the mean T2 relaxation time may reflect alterations in disease activity, and even when the conventional MRI and CFS remain stable.

Show MeSH
Related in: MedlinePlus