MRI for the demonstration of subclinical muscle involvement in muscular dystrophy

• Published in: Clinical radiology 2007-02, Vol.62 (2), p.160-165
• Main Authors: Sookhoo, S, MacKinnon, I, Bushby, K, Chinnery, P.F, Birchall, D
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; Diseases of striated muscles. Neuromuscular diseases; Female; Humans; Magnetic Resonance Imaging - methods; Male; Medical sciences; Middle Aged; Movement - physiology; Muscle Strength - physiology; Muscle, Skeletal - pathology; Muscle, Skeletal - physiopathology; Muscular Dystrophies - pathology; Muscular Dystrophies - physiopathology; Neurology; Radiology; Severity of Illness Index
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2006.08.012

Aim To compare magnetic resonance imaging (MRI) with clinical examination for the detection of muscle abnormality in patients with muscular dystrophy. Methods Muscle power in 20 patients with a variety of forms of muscular dystrophy was examined clinically using the Medical Research Council (MRC) grading scale, and patients were subsequently imaged with MRI. MRI and clinical examination for the detection of muscle normality and abnormality were compared using a McNemar chi-squared test to examine differences between the two methods. Results MRI demonstrated radiological evidence of muscle abnormality more often than clinical examination; 50% of movements assessed as normal on clinical examination were associated with muscle abnormalities on MRI, including a significant proportion where there was severe radiological abnormality, indicating that focally advanced disease may be undetectable clinically. Conclusion The combination of clinical examination and MRI could improve the accuracy of phenotypic characterization of patients with muscular dystrophy, and this in turn could allow a more focussed molecular analysis through muscle biopsy or genetic investigation. This may also be very helpful in the assessment of the degree of muscle compromise not only in the early phases of the disease but especially during follow-up and can be used in therapeutic trials.