Skeletal Muscle Magnetic Resonance Imaging of the Lower Limbs in Late-onset Lipid Storage Myopathy with Electron Transfer Flavoprotein Dehydrogenase Gene Mutations
Background: Lipid storage myopathy (LSM) is a genetically heterogeneous group with variable clinical phenotypes. Late-onset multiple acyl-coenzyme A dehydrogenation deficiency (MADD) is a rather common form of LSM in China. Diagnosis and clinical management of it remain challenging, especially witho...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2016-01-01
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| Series: | Chinese Medical Journal |
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| Online Access: | http://www.cmj.org/article.asp?issn=0366-6999;year=2016;volume=129;issue=12;spage=1425;epage=1431;aulast=Liu |
| _version_ | 1818544924250865664 |
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| author | Xin-Yi Liu Ming Jin Zhi-Qiang Wang Dan-Ni Wang Jun-Jie He Min-Ting Lin Hong-Xia Fu Ning Wang |
| author_facet | Xin-Yi Liu Ming Jin Zhi-Qiang Wang Dan-Ni Wang Jun-Jie He Min-Ting Lin Hong-Xia Fu Ning Wang |
| author_sort | Xin-Yi Liu |
| collection | DOAJ |
| description | Background: Lipid storage myopathy (LSM) is a genetically heterogeneous group with variable clinical phenotypes. Late-onset multiple acyl-coenzyme A dehydrogenation deficiency (MADD) is a rather common form of LSM in China. Diagnosis and clinical management of it remain challenging, especially without robust muscle biopsy result and genetic detection. As the noninvasion and convenience, muscle magnetic resonance imaging (MRI) is a helpful assistant, diagnostic tool for neuromuscular disorders. However, the disease-specific MRI patterns of muscle involved and its diagnostic value in late-onset MADD have not been systematic analyzed.
Methods: We assessed the MRI pattern and fat infiltration degree of the lower limb muscles in 28 late-onset MADD patients, combined with detailed clinical features and gene spectrum. Fat infiltration degree of the thigh muscle was scored while that of gluteus was described as obvious or not. Associated muscular atrophy was defined as obvious muscle bulk reduction.
Results: The mean scores were significantly different among the anterior, medial, and posterior thigh muscle groups. The mean of fat infiltration scores on posterior thigh muscle group was significantly higher than either anterior or medial thigh muscle group (P < 0.001). Moreover, the mean score on medial thigh muscle group was significantly higher than that of anterior thigh muscle group (P < 0.01). About half of the patients displayed fat infiltration and atrophy in gluteus muscles. Of 28 patients, 12 exhibited atrophy in medial and/or posterior thigh muscle groups, especially in posterior thigh muscle group. Muscle edema pattern was not found in all the patients.
Conclusions: Late-onset MADD patients show a typical muscular imaging pattern of fat infiltration and atrophy on anterior, posterior, and medial thigh muscle groups, with major involvement of posterior thigh muscle group and gluteus muscles and a sparing involvement of anterior thigh compartment. Our findings also suggest that muscle MRI of lower limbs is a helpful tool in guiding clinical evaluation on late-onset MADD. |
| first_indexed | 2024-12-11T22:54:48Z |
| format | Article |
| id | doaj.art-c279b3bc17ef47dd93cc6e51b4554075 |
| institution | Directory Open Access Journal |
| issn | 0366-6999 |
| language | English |
| last_indexed | 2024-12-11T22:54:48Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Chinese Medical Journal |
| spelling | doaj.art-c279b3bc17ef47dd93cc6e51b45540752022-12-22T00:47:19ZengWolters KluwerChinese Medical Journal0366-69992016-01-01129121425143110.4103/0366-6999.183423Skeletal Muscle Magnetic Resonance Imaging of the Lower Limbs in Late-onset Lipid Storage Myopathy with Electron Transfer Flavoprotein Dehydrogenase Gene MutationsXin-Yi LiuMing JinZhi-Qiang WangDan-Ni WangJun-Jie HeMin-Ting LinHong-Xia FuNing WangBackground: Lipid storage myopathy (LSM) is a genetically heterogeneous group with variable clinical phenotypes. Late-onset multiple acyl-coenzyme A dehydrogenation deficiency (MADD) is a rather common form of LSM in China. Diagnosis and clinical management of it remain challenging, especially without robust muscle biopsy result and genetic detection. As the noninvasion and convenience, muscle magnetic resonance imaging (MRI) is a helpful assistant, diagnostic tool for neuromuscular disorders. However, the disease-specific MRI patterns of muscle involved and its diagnostic value in late-onset MADD have not been systematic analyzed. Methods: We assessed the MRI pattern and fat infiltration degree of the lower limb muscles in 28 late-onset MADD patients, combined with detailed clinical features and gene spectrum. Fat infiltration degree of the thigh muscle was scored while that of gluteus was described as obvious or not. Associated muscular atrophy was defined as obvious muscle bulk reduction. Results: The mean scores were significantly different among the anterior, medial, and posterior thigh muscle groups. The mean of fat infiltration scores on posterior thigh muscle group was significantly higher than either anterior or medial thigh muscle group (P < 0.001). Moreover, the mean score on medial thigh muscle group was significantly higher than that of anterior thigh muscle group (P < 0.01). About half of the patients displayed fat infiltration and atrophy in gluteus muscles. Of 28 patients, 12 exhibited atrophy in medial and/or posterior thigh muscle groups, especially in posterior thigh muscle group. Muscle edema pattern was not found in all the patients. Conclusions: Late-onset MADD patients show a typical muscular imaging pattern of fat infiltration and atrophy on anterior, posterior, and medial thigh muscle groups, with major involvement of posterior thigh muscle group and gluteus muscles and a sparing involvement of anterior thigh compartment. Our findings also suggest that muscle MRI of lower limbs is a helpful tool in guiding clinical evaluation on late-onset MADD.http://www.cmj.org/article.asp?issn=0366-6999;year=2016;volume=129;issue=12;spage=1425;epage=1431;aulast=LiuElectron Transfer Flavoprotein Dehydrogenase; Fat Infiltration Atrophy; Late-onset Lipid Storage Myopathy; Magnetic Resonance Imaging; Multiple Acyl-coenzyme A Dehydrogenation Deficiency |
| spellingShingle | Xin-Yi Liu Ming Jin Zhi-Qiang Wang Dan-Ni Wang Jun-Jie He Min-Ting Lin Hong-Xia Fu Ning Wang Skeletal Muscle Magnetic Resonance Imaging of the Lower Limbs in Late-onset Lipid Storage Myopathy with Electron Transfer Flavoprotein Dehydrogenase Gene Mutations Chinese Medical Journal Electron Transfer Flavoprotein Dehydrogenase; Fat Infiltration Atrophy; Late-onset Lipid Storage Myopathy; Magnetic Resonance Imaging; Multiple Acyl-coenzyme A Dehydrogenation Deficiency |
| title | Skeletal Muscle Magnetic Resonance Imaging of the Lower Limbs in Late-onset Lipid Storage Myopathy with Electron Transfer Flavoprotein Dehydrogenase Gene Mutations |
| title_full | Skeletal Muscle Magnetic Resonance Imaging of the Lower Limbs in Late-onset Lipid Storage Myopathy with Electron Transfer Flavoprotein Dehydrogenase Gene Mutations |
| title_fullStr | Skeletal Muscle Magnetic Resonance Imaging of the Lower Limbs in Late-onset Lipid Storage Myopathy with Electron Transfer Flavoprotein Dehydrogenase Gene Mutations |
| title_full_unstemmed | Skeletal Muscle Magnetic Resonance Imaging of the Lower Limbs in Late-onset Lipid Storage Myopathy with Electron Transfer Flavoprotein Dehydrogenase Gene Mutations |
| title_short | Skeletal Muscle Magnetic Resonance Imaging of the Lower Limbs in Late-onset Lipid Storage Myopathy with Electron Transfer Flavoprotein Dehydrogenase Gene Mutations |
| title_sort | skeletal muscle magnetic resonance imaging of the lower limbs in late onset lipid storage myopathy with electron transfer flavoprotein dehydrogenase gene mutations |
| topic | Electron Transfer Flavoprotein Dehydrogenase; Fat Infiltration Atrophy; Late-onset Lipid Storage Myopathy; Magnetic Resonance Imaging; Multiple Acyl-coenzyme A Dehydrogenation Deficiency |
| url | http://www.cmj.org/article.asp?issn=0366-6999;year=2016;volume=129;issue=12;spage=1425;epage=1431;aulast=Liu |
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