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MRI assessment of the thigh musculature in dermatomyositis and healthy subjects using diffusion tensor imaging, intravoxel incoherent motion and dynamic DTI

  • Musculoskeletal
  • Published:
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A Correction to this article was published on 09 July 2018

This article has been updated

Abstract

Introduction

Dermatomyositis (DM) is an idiopathic inflammatory myopathy involving severe debilitation in need of diagnostics. We evaluated the proximal lower extremity musculature with diffusion tensor imaging (DTI), intravoxel incoherent motion (IVIM) and dynamic DTI in DM patients and controls and compared with standard clinical workup. 

Methods

In this IRB-approved, HIPAA-compliant study with written informed consent, anatomical, Dixon fat/water and diffusion imaging were collected in bilateral thigh MRI of 22 controls and 27 DM patients in a 3T scanner. Compartments were scored on T1/T2 scales. Single voxel dynamic DTI metrics in quadriceps before and after 3-min leg exercise were measured. Spearman rank correlation and mixed model analysis of variance/covariance (ANOVA/ANCOVA) were used to correlate with T1 and T2 scores and to compare patients with controls.

Results

DM patients showed significantly lower pseudo-diffusion and volume in quadriceps than controls. All subjects showed significant correlation between T1 score and signal-weighted fat fraction; tissue diffusion and pseudo-diffusion varied significantly with T1 and T2 score in patients. Radial and mean diffusion exercise response in patients was significantly higher than controls.

Conclusion

Static and dynamic diffusion imaging metrics show correlation with conventional imaging scores, reveal spatial heterogeneity, and provide means to differentiate dermatomyositis patients from controls.

Key Points

• Diffusion imaging shows regional differences between thigh muscles of dermatomyositis patients and controls.

• Signal-weighted fat fraction and diffusion metrics correlate with T1/T2 scores of disease severity.

• Dermatomyositis patients show significantly higher radial diffusion exercise response than controls.

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Change history

  • 09 July 2018

    The original version of this article, published on 04 June 2018, unfortunately contained a mistake.

Abbreviations

AD:

Adductor magnus

ANCOVA:

Analysis of covariance

ANOVA:

Analysis of variance

BF:

Biceps femoris

CK:

Creatine kinase

DM:

Dermatomyositis

DTI:

Diffusion tensor imaging

DWI:

Diffusion-weighted imaging

ECG:

Electrocardiogram

FA:

Fractional anisotropy

GRE:

Gradient echo

IVIM:

Intravoxel incoherent motion

MD:

Mean diffusivity

MMT:

Manual muscle test

PC:

Phase contrast

RF:

Rectus femoris

ROI:

Region of interest

SM:

Semimembranosus

SPAIR:

Spectral adiabatic inversion recovery

ST:

Semitendinosus

SV-MEDITATE:

Single voxel multiple echo diffusion tensor acquisition technique

SWFF:

Signal-weighted fat fraction

TSE:

Turbo spin echo

VI:

Vastus intermedius

VL:

Vastus lateralis

VM:

Vastus medialis

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, New York University Langone Medical Center, 660 First Ave., New York, NY, 10016, USA

    E. E. Sigmund, S. H. Baete, T. Luo, K. Patel, D. Wang, I. Rossi, A. Duarte, M. Bruno, D. Mossa, D. Stoffel, J. S. Babb & J. Bencardino

  2. Bernard and Irene Schwartz Center for Biomedical Imaging (CBI), New York University Langone Medical Center, New York, NY, USA

    E. E. Sigmund, S. H. Baete, T. Luo, K. Patel, D. Wang, M. Bruno, D. Mossa, D. Stoffel & J. S. Babb

  3. Center for Advanced Imaging and Innovation (CAI2R), New York University Langone Medical Center, New York, NY, USA

    E. E. Sigmund, S. H. Baete, M. Bruno, D. Mossa, D. Stoffel & J. S. Babb

  4. Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, NY, USA

    A. Femia, S. Ramachandran & A. G. Franks

  5. Division of Biostatistics, New York University Langone Medical Center, New York, NY, USA

    J. S. Babb

  6. Department of Medicine, Division of Rheumatology, New York University Langone Medical Center, New York, NY, USA

    A. G. Franks

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  1. E. E. Sigmund
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  2. S. H. Baete
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  3. T. Luo
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Corresponding author

Correspondence to E. E. Sigmund.

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Guarantor

The scientific guarantor of this publication is Eric E. Sigmund, PhD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (J.S. Babb) has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• cross-sectional study

• performed at one institution

Additional information

The original version of this article was revised: The name of A.G. Franks was presented incorrectly and one of his affiliations was missing.

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Sigmund, E.E., Baete, S.H., Luo, T. et al. MRI assessment of the thigh musculature in dermatomyositis and healthy subjects using diffusion tensor imaging, intravoxel incoherent motion and dynamic DTI. Eur Radiol 28, 5304–5315 (2018). https://doi.org/10.1007/s00330-018-5458-3

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