Journal of Neurology

, Volume 264, Issue 9, pp 1899–1908 | Cite as

Magnetic resonance imaging of leg muscles in patients with myotonic dystrophies

  • Stojan Peric
  • Ruzica Maksimovic
  • Bojan Banko
  • Milica Durdic
  • Bogdan Bjelica
  • Ivo Bozovic
  • Yunus Balcik
  • Jovan Pesovic
  • Dusanka Savic-Pavicevic
  • Vidosava Rakocevic-StojanovicEmail author
Original Communication


Magnetic resonance imaging (MRI) of muscles has recently become a significant diagnostic procedure in neuromuscular disorders. There is a lack of muscle MRI studies in patients with myotonic dystrophy type 1 (DM1), especially type 2 (DM2). To analyze fatty infiltration of leg muscles, using 3.0 T MRI in patients with genetically confirmed DM1 and DM2 with different disease durations. The study comprised 21 DM1 and 10 DM2 adult patients. Muscle MRI was performed in axial plane of the lower limbs using T1-weighted (T1w) sequence. Six-point scale by Mercuri et al. was used. Fatty infiltration registered in at least one muscle of lower extremities was found in 71% of DM1 and 40% of DM2 patients. In DM1 patients, early involvement of the medial head of gastrocnemius and tibialis anterior muscles was observed with later involvement of other lower leg muscles and of anterior and posterior thigh compartments with relative sparing of the rectus femoris. In DM2, majority of patients had normal MRI findings. Early involvement of lower legs and posterior thighs was found in some patients. Less severe involvement of the medial head of the gastrocnemius compared to other lower leg muscles was also observed, while involvement of proximal muscles was rather diffuse than selective. It seems that both in DM1 and DM2 some muscles may be affected before weakness is clinically noted and vice versa. We described characteristic pattern and way of progression of muscle involvement in DM1 and DM2.


Myotonic dystrophy type 1 Myotonic dystrophy type 2 Muscle magnetic resonance imaging Legs Progression Fatty infiltration 



Myotonic dystrophy type 1


Myotonic dystrophy type 2




Muscle Impairment Rating Scale


Medical Research Council


Muscle resonance imaging


Proton density weighted






Triplet repeat primed polymerase chain reaction



This study was supported by the Ministry of Education, Science and Technological Development of Serbia granted to V.R.S. (Grant # 175083).

Compliance with ethical standards

Conflicts of interest

None of the authors has any conflict of interest to disclose.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Stojan Peric
    • 1
  • Ruzica Maksimovic
    • 2
  • Bojan Banko
    • 2
  • Milica Durdic
    • 2
  • Bogdan Bjelica
    • 1
  • Ivo Bozovic
    • 1
  • Yunus Balcik
    • 1
  • Jovan Pesovic
    • 3
  • Dusanka Savic-Pavicevic
    • 3
  • Vidosava Rakocevic-Stojanovic
    • 1
    Email author
  1. 1.Neurology Clinic, Clinical Centre of Serbia, School of MedicineUniversity of BelgradeBelgradeSerbia
  2. 2.Centre for Radiology and Magnetic Resonance Imaging, Clinical Centre of Serbia, School of MedicineUniversity of BelgradeBelgradeSerbia
  3. 3.Faculty of Biology, Centre for Human Molecular GeneticsUniversity of BelgradeBelgradeSerbia

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