Myocardial injury in Duchenne muscular dystrophy: assessment via cardiac magnetic resonance intra-voxel incoherent motion.

Abstract

Duchenne muscular dystrophy (DMD) is a progressive myopathy caused by a mutation in the dystrophin gene. Cardiac disease is currently the leading cause of death in patients with DMD; thus, early diagnosis and management of cardiomyopathy are essential. Intra-voxel incoherent motion (IVIM) analysis provides quantitative values from diffusion-weighted imaging (DWI) and may serve as a novel index for evaluating myocardial properties in DMD. We conducted IVIM analysis in patients with DMD and compared their results with those of healthy volunteers to confirm that IVIM analysis can detect myocardial damage more effectively than conventional imaging methods. Patients with DMD who underwent cardiac magnetic resonance IVIM were enrolled. D and F values were measured using DWI of the left ventricle. Six healthy volunteers served as the control group. Twelve male patients with DMD were enrolled (median age, 14 years). Creatinine kinase levels were elevated, brain natriuretic peptide values remained within the normal range, and troponin T levels were only mildly elevated. The D value in patients with DMD was significantly higher than that in healthy volunteers, indicating increased diffusion in the myocardium (2.59 vs. 1.85, p = 0.0057); however, the F value was comparable between the two groups (0.62 vs. 0.61, p = 0.60). The D and F values from IVIM analysis provided a more detailed reflection of myocardial properties. Myocardial diffusion in patients with DMD was elevated compared with that in healthy volunteers.