Rammohan Vadapalli MD, Presenter: Nothing to Disclose

Meena Ak MD, DPhil, Abstract Co-Author: Nothing to Disclose

Kashyap Lp MD, Abstract Co-Author: Nothing to Disclose

To Evaluate the role of Proton MRS   Inflammatory Myopathies of  skeletal muscles in Clinical Imaging practice

15 normal age sex and BMI  matched controls and 15 patients with M:F ratio 2:3 and age range of  44-70Y with mean age of 57 years were included in the study. Patient cateogories Included: Diabetic Myositis (n=4), Viral Myositis (=5),Poly Myositis(n=2), Dermatomyositis(=3),Inclusion body Myositis(1). All  Controls and patients were Imaged on 3T Achieva MR scanner(Philips Medical Systems,Netherland) with following protocol: Scout,T1Coronal,STIR Coronal,T2 coronal followed by Proton MRS with following parameters. 2D PRESS MR spectroscopy sequence single and multi Voxel with following parameters:SIngle Voxel watersuppression,TR 2000 TE 44.144.288 msec, Matrix 24x24.  The spectral data for multi voxel were obtained from an 8-mL voxel (2 x 2 x 2 cm 2,000/144;  slice thickness 1 cm;  25cm field of view from the sites of signal abnormalities in calf muscles of both legs Data were then Post processed and analyzed for following: Hieght of IMCL (Intramyocellular Lipids) and EMCL(Extra Myocellular Lipids) EMCL/cr ratio,IMCL/cr ratio and EMCL and IMCL fractions were then calculated and generated  

Normal controls  IMCL/cr ratio mean of 2.5 and EMCL/cr ratio mean of 3.7 in calf muscles Choline creatine ratio :mean value of 1.1 in calf muscles and 1.26 in Patient group Diabetic Myositis(n=6) :  Mean IMCL/Cr ratio of .0.4 with grossly reduced IMCL and an EMCL/Cr fraction of 1.56 with a symmetrical pattern Poly Myositis (n=5) : Mean IMCL/Cr ratio of 0.7 with grossly reduced IMCL and an EMCL/Cr fraction of  2.2 with an  asymmetrical pattern   Inclusion body Mysoitis(n=3):  Mean IMCL/Cr ratio of 0.27 with grossly reduced IMCL and an EMCL/Cr fraction of  1.7 with near symmetrical pattern   Infective myositis (n=2): (NCC and Tuberculous):  Mean IMCL/Cr ratio of  1.9 with  moderate to mildly  reduced IMCL and an EMCL/Cr fraction of  2.8  with asymmetrical pattern      

Proton  MR Spectroscopy  is a Non invasive , useful adjunct technique for characterization and quantification  of Myonecrosis and Myoinflmmation in Inflmmatory myopathies .

 MRS adds new Biomarkers for diagnostic characterization of Inflamatory myopathies by quantification of IMCL fraction  from symmetric and Asymmetric  signal abnormalities of involved muscles

Vadapalli, R, Ak, M, Lp, K, Proton MR Spectroscopy of Inflammatory Myopathies in Clinical Imaging Practice.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8010345.html