Netanel Berko MD, Presenter: Nothing to Disclose

Arielle Hay MD, Abstract Co-Author: Nothing to Disclose

Yonit Sterba MD, Abstract Co-Author: Nothing to Disclose

Dawn Wahezi MD, MS, Abstract Co-Author: Nothing to Disclose

Hillel Cohen PhD, MPH, Abstract Co-Author: Nothing to Disclose

Terry L. Levin MD, Abstract Co-Author: Nothing to Disclose

To compare strain ultrasound elastography with magnetic resonance imaging (MRI) of the quadriceps muscles for the detection of active myositis in children with inflammatory myositides.

Multisequence noncontrast MRI of the quadriceps muscles was compared to grey scale and cine ultrasound elastography in eighteen children with inflammatory myositides (15 juvenile dermatomyositis, 2 systemic lupus erythematosus, 1 polymyositis; 15 girls, 3 boys; mean age 10.5 +/- 4.7 years; range 3-19 years). Active myositis was defined on MRI as increased muscle signal on T2-weighted images. Elastography images were evaluated based on a previously published numerical scale of muscle elastography in normal children by two radiologists in consensus, blinded to the patients’ MRI findings. Disease duration, serum muscle enzyme levels, and clinical assessment of active versus inactive disease were correlated with imaging findings. Statistical analyses were performed with Fisher’s exact test, Spearman’s correlation and Mann-Whitney U test as appropriate. P- value < 0.05 indicated statistical significance.

Quadriceps muscle signal was normal on T1- weighted images in all subjects. T2 hyperintensity was present in 9 subjects; of these, elastography was abnormal in two (decreased elasticity) and normal in seven. Twelve patients had normal MRI; elastography was normal in 7 and abnormal in 5 (decreased elasticity). MRI signal hyperintensity and increased muscle echogenicity correlated strongly with clinically active disease (p = 0.035 and p = 0.015, respectively). However, there was no significant correlation between elastography and clinically active disease (p = 0.144), or elastography and MRI (p = 0.64). A nonsignificant trend toward decreased muscle elasticity in children with longer disease duration was present (p = 0.265).

Ultrasound elastography does not accurately detect active myositis in children with inflammatory myositis.

Ultrasound elastography does not replace MRI as the gold standard for detecting active myositis in children.

Berko, N, Hay, A, Sterba, Y, Wahezi, D, Cohen, H, Levin, T, Efficacy of Ultrasound Elastography in Detecting Active Myositis in Children. Can It Replace MRI?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002880.html