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The diagnostic value of biexponential apparent diffusion coefficients in myopathy

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Abstract

To investigate the performance of a biexponential signal decay model using DWI in myopathies and to differentiate Polymyositis (PM)/Dermatomyositis (DM), Glycogen Storage Diseases (GSDs) and Muscular Dystrophies (MDs) utilizing diffusion-weighted imaging. 11 healthy volunteers (control group) and 46 patients with myopathy were enrolled in the retrospective study. 27 of 46 patients had PM/DM, 7 patients GSDs and 12 patients MDs. After conventional MR sequences, diffusion weighted imaging with a b-factor ranging from 0 to 1200 s/mm2 was performed on both thighs. The intra-muscular signal-to-noise ratios (SNRs) on multiple-b DWI images were measured for 7 different muscles and compared among the different groups. The median T2 signal intensity and biexponential apparent diffusion coefficients (ADC), including standard ADC, fast ADC, and slow ADC values, were compared among the different groups. The intra-muscular SNRs were statistically significantly different depending on the b value, and also found among the 4 groups (p < 0.05). The median T2 signal intensity of the normal muscles in control group was statistically significantly lower than that of edematous muscles in the PM/DM, GSDs and MDs groups (p = 0.000), while there were no statistically significant differences among the PM/DM, GSDs, and MDs groups (p > 0.05). The median standard ADC value of the edematous muscles in GSDs was statistically significantly lower than that of normal muscles in the control group (p = 0.000) and the median ADC value of the edematous muscles in PM/DM patients was statistically significantly greater than that of the GSDs (p = 0.000) and MDs groups (p = 0.005). The median slow ADC value of the edematous muscles in MDs patients and PM/DM patients was statistically significantly greater than that of GSDs patients (p < 0.05). Intra-muscular SNR decay curves and biexponential ADC parameters are useful in distinguishing among PM/DM, GSDs, and MDs.

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Acknowledgments

This research was supported by the projects from National Scientific foundation of China (NSFC, No. 81320108013, 81571643 & 31170899).  

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Authors and Affiliations

  1. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095, Jiefang Road, Wuhan, 430030, Hubei, China

    Jun Ran, Yao Liu, Dong Sun, Gang Wu, Yuda Sheng, Ruyi Xie, Xiaoli Zhang & Xiaoming Li

  2. Department of Radiology, St John’s Medical Center, Tulsa, OK, USA

    John Morelli

  3. Department of Radiology, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China

    Ping Zhang

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  1. Jun Ran
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  2. Yao Liu
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  3. Dong Sun
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  6. Gang Wu
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  9. Xiaoli Zhang
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  10. Xiaoming Li
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Correspondence to Xiaoming Li.

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Ran, J., Liu, Y., Sun, D. et al. The diagnostic value of biexponential apparent diffusion coefficients in myopathy. J Neurol 263, 1296–1302 (2016). https://doi.org/10.1007/s00415-016-8139-7

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  • DOI: https://doi.org/10.1007/s00415-016-8139-7

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