Fatty infiltration in the posterior muscles of the lower extremities as an MRI feature in antimitochondrial antibody–associated myopathy,Clinical Rheumatology

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Fatty infiltration in the posterior muscles of the lower extremities as an MRI feature in antimitochondrial antibody–associated myopathy
Clinical Rheumatology ( IF 2.9 ) Pub Date : 2024-01-29 , DOI: 10.1007/s10067-024-06877-9
Yuli Wang ₁ , Zhenguo Huang ₁ , Jieping Lei ₂ , Xin Lu ₃ , Sizhao Li ₃ , Guochun Wang ₃ , Sheng Xie ₁ , Lu Zhang ₃

Affiliation

Objective

Idiopathic inflammatory myopathy (IIM) with antimitochondrial M2 antibody (AMA-M2) has been associated with distinct clinical characteristics. In this study, we explore the magnetic resonance imaging (MRI) findings of the muscles of the lower extremities in AMA-M2-positive IIM to gain more insight.

Methods

MRI of 22 lower extremity muscles was retrospectively evaluated in 14 patients with AMA-M2-positive IIM and 37 age- and sex-matched patients with AMA-M2-negative IIM. Muscles with inflammatory edema and fatty infiltration were assessed according to the Stramare and Mercuri criteria.

Results

Patients with AMA-M2-positive IIM had significantly higher incidence of MRI involvement with fatty infiltration in five lower extremity muscles, namely the adductor magnus (AM) (13/14 VS 14/37, p < 0.001), semimembranosus (SM) (13/14 VS 17/37, p = 0.002), biceps femoris (BF) (12/14 VS 15/37, p = 0.004), soleus (13/14 VS 23/37, p = 0.041), and the medial head of the gastrocnemius (Gastroc M) (13/14 VS 17/37, p = 0.002) than patients with AMA-M2-negative IIM. Furthermore, the severity scores of fatty infiltrations of the above five muscles in AMA-M2-positive IIM were significantly higher than those in patients with AMA-M2-negative IIM (p < 0.001).

Conclusions

Severe fatty infiltrations of the AM, SM, BF, soleus, and Gastroc M in the posterior muscles of the lower extremities are dominant MRI features in our patients with AMA-M2-positive IIM. This unique muscle MRI character may be a helpful indicator in clinical practice for patients with AMA-M2-positive IIM.

Key Points

• Striking involvement and prominent fatty infiltrations of five lower extremity muscles (adductor magnus, semimembranosus, biceps femoris, soleus, and the medial head of the gastrocnemius) are interesting MRI performances.

• Severe fatty infiltrations in the posterior muscles of the lower extremities are dominant MRI features in AMA-M2-positive IIM.

• This unique muscle MRI character may be very helpful for the diagnosis of the AMA-M2-positive IIM.

中文翻译：

下肢后部肌肉脂肪浸润作为抗线粒体抗体相关性肌病的 MRI 特征

客观的

抗线粒体 M2 抗体 (AMA-M2) 引起的特发性炎症性肌病 (IIM) 具有独特的临床特征。在这项研究中，我们探讨了 AMA-M2 阳性 IIM 下肢肌肉的磁共振成像 (MRI) 结果，以获得更多见解。

方法

回顾性评估了 14 名 AMA-M2 阳性 IIM 患者和 37 名年龄和性别匹配的 AMA-M2 阴性 IIM 患者的 22 块下肢肌肉的 MRI。根据 Stramare 和 Mercuri 标准评估具有炎性水肿和脂肪浸润的肌肉。

结果

AMA-M2 阳性 IIM 患者的 MRI 受累率显着较高，其中五块下肢肌肉有脂肪浸润，即大收肌 (AM) (13/14 VS 14/37， p < 0.001)、半膜肌 (SM)（ 13/14 VS 17/37， p = 0.002)、股二头肌 (BF) (12/14 VS 15/37， p = 0.004)、比目鱼肌 (13/14 VS 23/37， p = 0.041) 和内侧腓肠肌头 (Gastroc M) (13/14 VS 17/37, p = 0.002) 高于 AMA-M2 阴性 IIM 患者。此外，AMA-M2 阳性 IIM 患者上述五块肌肉的脂肪浸润严重程度评分显着高于 AMA-M2 阴性 IIM 患者（ p < 0.001）。