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Whole-body MRI and pathological findings in adult patients with myopathies

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Abstract

Magnetic resonance imaging (MRI) is considered the most sensitive and specific imaging technique for the detection of muscle diseases related to myopathies. Since 2008, the use of whole-body MRI (WBMRI) to evaluate myopathies has improved due to technical advances such as rolling table platform and parallel imaging, which enable rapid assessment of the entire musculoskeletal system with high-quality images. WBMRI protocols should include T1-weighted and short-tau inversion recovery (STIR), which provide the basic pulse sequences for studying myopathies, in order to detect fatty infiltration/muscle atrophy and muscle edema, respectively. High signal intensity in T1-weighted images shows chronic disease with fatty infiltration, whereas high signal intensity in STIR indicates an acute stage with muscle edema. Additional sequences such as diffusion-weighted imaging (DWI) can be readily incorporated into routine WBMRI study protocols. Contrast-enhanced sequences have not been done. This article reviews WBMRI as an imaging method to evaluate different myopathies (idiopathic inflammatory, dystrophic, non-dystrophic, metabolic, and channelopathies). WBMRI provides a comprehensive estimate of the total burden with a single study, seeking specific distribution patterns, including clinically silent involvement of muscle areas. Furthermore, WBMRI may help to select the “target muscle area” for biopsy during patient follow-up. It may be also be used to detect related and non-related pathological conditions, such as tumors.

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Acknowledgements

We thank our MRI technicians Santiago Sotes and Irene Millan, and Donna Pringle and Jennifer Brickman for reviewing and improving the manuscript.

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Authors and Affiliations

  1. Department of Radiology (CDIC), Hospital Clinic, Universitat de Barcelona (UB), Villarroel 170, 08036, Barcelona, Spain

    Xavier Tomas, Ana Isabel Garcia-Diez & Jaime Pomes

  2. Department of Internal Medicine, Hospital Clinic, Universitat de Barcelona (UB) and CIBERER, Villarroel 170, 08036, Barcelona, Spain

    Jose Cesar Milisenda & Josep Maria Grau-Junyent

  3. Department of Autoimmune Diseases, Hospital Clinic, Universitat de Barcelona (UB), Villarroel 170, 08036, Barcelona, Spain

    Sergio Prieto-Gonzalez

  4. Department of Radiology, Hopital Purpan, Centre Hospitalier Universitaire (CHU), Place du Docteur Baylac TSA 40031, 31059, Toulouse cedex 9, France

    Marie Faruch

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Tomas, X., Milisenda, J.C., Garcia-Diez, A.I. et al. Whole-body MRI and pathological findings in adult patients with myopathies. Skeletal Radiol 48, 653–676 (2019). https://doi.org/10.1007/s00256-018-3107-1

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