Dynamic MR of muscle contraction during electrical muscle stimulation as a potential diagnostic tool for neuromuscular disease

Francesco Santini, Michele Giovanni Croce, Xeni Deligianni, Matteo Paoletti, Leonardo Barzaghi, Niels Bergsland, Arianna Faggioli, Giulia Manco, Chiara Bonizzoni, Ning Jin, Sabrina Ravaglia, Anna Pichiecchio
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Abstract

Thanks to the rapid evolution of therapeutic strategies for muscular and neuromuscular diseases, the identification of quantitative biomarkers for disease identification and monitoring has become crucial. Magnetic resonance imaging (MRI) has been playing an important role by noninvasively assessing structural and functional muscular changes. This exploratory study investigated the potential of dynamic MRI during neuromuscular electrical stimulation (NMES) to detect differences between healthy controls (HCs) and patients with metabolic and myotonic myopathies. The study included 14 HCs and 10 patients with confirmed muscular diseases. All individuals were scanned with 3T MRI with a protocol that included a multi-echo gradient echo sequence for fat fraction quantification, multi-echo spin-echo for water T2 relaxation time calculation, and 3D phase contrast sequences during NMES. The strain tensor, buildup and release rates were calculated from velocity datasets. Results showed that strain and strain buildup rate were reduced in the soleus muscle of patients compared to HCs, suggesting these parameters could serve as biomarkers of muscle dysfunction. Notably, there were no significant differences in fat fraction or water T2 measurements between patients and HCs, indicating that the observed changes reflect alterations in muscle contractile properties that are not reflected by structural changes. The findings provide preliminary evidence that dynamic muscle MRI during NMES can detect abnormalities in muscle contraction in patients with myotonia and metabolic myopathies, warranting further research with larger, more homogeneous patient cohorts.
肌肉电刺激时肌肉收缩的动态磁共振成像,作为神经肌肉疾病的潜在诊断工具
由于肌肉和神经肌肉疾病治疗策略的快速发展,确定用于疾病识别和监测的定量生物标志物已变得至关重要。磁共振成像(MRI)通过无创评估肌肉的结构和功能变化发挥了重要作用。这项探索性研究调查了神经肌肉电刺激(NMES)期间动态 MRI 检测健康对照组(HC)与代谢性肌病和肌强直性肌病患者之间差异的潜力。该研究包括 14 名健康对照者和 10 名确诊肌肉疾病患者。所有患者均接受了 3T 磁共振成像扫描,扫描方案包括用于脂肪分数量化的多回波梯度回波序列、用于计算水 T2 松弛时间的多回波自旋回波以及 NMES 期间的三维相位对比序列。根据速度数据集计算了应变张量、堆积率和释放率。结果显示,与普通人相比,患者比目鱼肌的应变和应变积聚率降低,这表明这些参数可作为肌肉功能障碍的生物标志物。值得注意的是,患者和 HC 之间的脂肪分数或水 T2 测量值没有明显差异,这表明观察到的变化反映了肌肉收缩特性的改变,而不是结构变化所反映的。这些发现提供了初步证据,证明在 NMES 期间进行动态肌肉 MRI 可检测肌张力障碍和代谢性肌病患者的肌肉收缩异常,因此有必要对规模更大、同质性更高的患者群体进行进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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