影像技术在皮肌炎诊断和病情评估中的研究进展

doi:10.35541/cjd.20200447

中华皮肤科杂志 ›› 2022, Vol. 55 ›› Issue (7): 637-640.doi: 10.35541/cjd.20200447

影像技术在皮肌炎诊断和病情评估中的研究进展

张诗敏¹ 胡赟赟² 赵肖庆¹ 杜联军³ 曹华¹ 郑捷¹

¹上海交通大学医学院附属瑞金医院皮肤科，上海 200025；²上海交通大学医学院附属瑞金医院超声科，上海 200025；³上海交通大学医学院附属瑞金医院放射科，上海 200025

收稿日期:2020-05-09 修回日期:2020-11-12 发布日期:2022-07-05
通讯作者: 曹华；杜联军 E-mail:drcaohua@126.com; dlj10788@rjh.com.cn
基金资助:
国家自然科学基金（81573037、81872523）；国家临床重点专科建设项目（2012649）；上海市科委科研计划项目（134119a6100）；上海申康医院发展中心临床创新能力三年行动计划项目（16CR3084B）；上海交通大学医学院高峰学科——临床医学研究型医师项目（20172009）；上海市“医苑新星”杰出青年医学人才培养资助计划（2019）

Application of imaging techniques in diagnosis and severity assessment of dermatomyositis

Zhang Shimin¹, Hu Yunyun², Zhao Xiaoqing¹, Du Lianjun³, Cao Hua¹, Zheng Jie¹

¹Department of Dermatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; ²Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; ³Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received:2020-05-09 Revised:2020-11-12 Published:2022-07-05
Contact: Cao Hua; Du Lianjun E-mail:drcaohua@126.com; dlj10788@rjh.com.cn
Supported by:
National Natural Science Foundation of China （81573037, 81872523）; National Clinical Key Subject Construction Project （2012649）; Scientific Research Project of Shanghai Science and Technology Committee（134119a6100）; Clinical Research Plan of Shanghai Shen-kang Hospital Development Center （16CR3084B）; Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support （20172009）; Shanghai "Rising Stars of Medical Talent" Youth Development Program-Outstanding Youth Medical Talents （2019）

摘要/Abstract

摘要： 【摘要】皮肌炎是一种累及皮肤和肌肉的自身免疫性疾病，起病时临床表现不典型且缺乏血清学标记物，早期诊断较为困难。皮肌炎和临床无肌病性皮肌炎的皮损和肌肉病变与疾病活动性及预后相关，通过CT、核磁共振成像、超声、皮肤镜等影像学技术评估皮肤和肌肉受累情况，不仅可以提高皮肌炎早期诊断的准确性，而且可以为疾病活动及预后评估提供重要依据。

关键词: 皮肌炎, 皮肤表现, 神经肌肉表现, 工艺学、放射学, 临床无肌病性皮肌炎

Abstract: 【Abstract】 Dermatomyositis is an autoimmune disease involving the skin and muscles. At the onset of dermatomyositis, it is difficult to make an early diagnosis due to atypical clinical manifestations and lack of serological markers. Skin and muscle lesions are associated with disease activity and prognosis in patients with dermatomyositis or clinical amyopathic dermatomyositis. Computed tomography, magnetic resonance imaging, ultrasonography, dermoscopy and other imaging techniques may be used to assess skin and muscle involvements, which can not only improve the accuracy of early diagnosis of dermatomyositis, but also provide important reference for the assessment of disease activity and prognosis.

Key words: Dermatomyositis, Skin manifestations, Neuromuscular manifestations, Technology, radiologic, Clinically amyopathic dermatomyositis

张诗敏胡赟赟赵肖庆杜联军曹华郑捷. 影像技术在皮肌炎诊断和病情评估中的研究进展[J]. 中华皮肤科杂志, 2022,55(7):637-640. doi:10.35541/cjd.20200447

Zhang Shimin, Hu Yunyun, Zhao Xiaoqing, Du Lianjun, Cao Hua, Zheng Jie. Application of imaging techniques in diagnosis and severity assessment of dermatomyositis[J]. Chinese Journal of Dermatology, 2022, 55(7): 637-640.doi:10.35541/cjd.20200447

参考文献 30

［1］	Cao H, Parikh TN, Zheng J. Amyopathic dermatomyositis or dermatomyositis⁃like skin disease: retrospective review of 16 cases with amyopathic dermatomyositis［J］. Clin Rheumatol, 2009,28（8）:979⁃984. doi: 10.1007/s10067⁃009⁃1152⁃9.
［2］	Bertolazzi C, Cutolo M, Smith V, et al. State of the art on nailfold capillaroscopy in dermatomyositis and polymyositis［J］. Semin Arthritis Rheum, 2017,47（3）:432⁃444. doi: 10.1016/j.semarthrit. 2017.06.001.
［3］	Elmansour I, Chiheb S, Benchikhi H. Nail changes in connective tissue diseases: a study of 39 cases［J］. Pan Afr Med J, 2014,18:150. doi: 10.11604/pamj.2014.18.150.4637.
［4］	Deegan AJ, Wang RK. Microvascular imaging of the skin［J］. Phys Med Biol, 2019,64（7）:07TR01. doi: 10.1088/1361⁃6560/ab03f1.
［5］	Jasso⁃Olivares JC, Tosti A, Miteva M, et al. Clinical and dermoscopic features of the scalp in 31 patients with dermatomyositis［J］. Skin Appendage Disord, 2017,3（3）:119⁃124. doi: 10.1159/000464469.
［6］	Miteva M, Tosti A. Hair and scalp dermatoscopy［J］. J Am Acad Dermatol, 2012,67（5）:1040⁃1048. doi: 10.1016/j.jaad.2012.02. 013.
［7］	Chung MP, Richardson C, Kirakossian D, et al. Calcinosis biomarkers in adult and juvenile dermatomyositis［J］. Autoimmun Rev, 2020,19（6）:102533. doi: 10.1016/j.autrev.2020. 102533.
［8］	Hoeltzel MF, Oberle EJ, Robinson AB, et al. The presentation, assessment, pathogenesis, and treatment of calcinosis in juvenile dermatomyositis［J］. Curr Rheumatol Rep, 2014,16（12）:467. doi: 10.1007/s11926⁃014⁃0467⁃y.
［9］	Blane CE, White SJ, Braunstein EM, et al. Patterns of calcification in childhood dermatomyositis［J］. AJR Am J Roentgenol, 1984,142（2）:397⁃400. doi: 10.2214/ajr.142.2.397.
［10］	Shahi V, Wetter DA, Howe BM, et al. Plain radiography is effective for the detection of calcinosis cutis occurring in association with autoimmune connective tissue disease［J］. Br J Dermatol, 2014,170（5）:1073⁃1079. doi: 10.1111/bjd.12785.
［11］	Hughes M, Hodgson R, Harris J, et al. Imaging calcinosis in patients with systemic sclerosis by radiography, computerised tomography and magnetic resonance imaging［J］. Semin Arthritis Rheum, 2019,49（2）:279⁃282. doi: 10.1016/j.semarthrit.2019.03. 001.
［12］	Hsu V, Bramwit M, Schlesinger N. Use of dual⁃energy computed tomography for the evaluation of calcinosis in patients with systemic sclerosis［J］. Clin Rheumatol, 2015,34（9）:1557⁃1561. doi: 10.1007/s10067⁃015⁃2998⁃7.
［13］	国家皮肤与免疫疾病临床医学研究中心, 中国医师协会皮肤科医师分会皮肤外科亚专业委员会, 中国中西医结合学会皮肤性病学专业委员会皮肤影像学组, 等. 常见皮肤病高频皮肤超声诊断专家共识［J］. 中国医学前沿杂志（电子版）, 2019,11（8）:23⁃28. doi: 10.12037/YXQY.2019.08⁃04.
［14］	Romaní J, Giavedoni P, Roé E, et al. Inter⁃ and intra⁃rater agreement of dermatologic ultrasound for the diagnosis of lobular and septal panniculitis［J］. J Ultrasound Med, 2020,39（1）:107⁃112. doi: 10.1002/jum.15080.
［15］	中国中西医结合学会皮肤性病学专业委员会皮肤影像学组, 国家远程医疗与互联网医学中心皮肤科专委会, 国家皮肤与免疫疾病临床医学研究中心, 等. 炎症性皮肤病反射式共聚焦显微镜诊断特征专家共识［J］. 中国医学前沿杂志（电子版）, 2019,11（8）:34⁃40. doi: 10.12037/YXQY.2019.08⁃06.
［16］	Berekméri A, Tiganescu A, Alase AA, et al. Non⁃invasive approaches for the diagnosis of autoimmune/autoinflammatory skin diseases⁃a focus on psoriasis and lupus erythematosus［J］. Front Immunol, 2019,10:1931. doi: 10.3389/fimmu.2019.01931.
［17］	Targoff IN, Miller FW, Medsger TA Jr, et al. Classification criteria for the idiopathic inflammatory myopathies［J］. Curr Opin Rheumatol, 1997,9（6）:527⁃535. doi: 10.1097/00002281⁃199711000⁃00008.
［18］	Paramalingam S, Counsel P, Mastaglia FL, et al. Imaging in the diagnosis of idiopathic inflammatory myopathies; indications and utility［J］. Expert Rev Neurother, 2019,19（2）:173⁃184. doi: 10. 1080/14737175.2019.1572507.
［19］	Huang Z, Yang M, Chen X, et al. Value of whole⁃body magnetic resonance imaging for screening multifocal osteonecrosis in patients with polymyositis/dermatomyositis［J］. Br J Radiol, 2017,90（1073）:20160780. doi: 10.1259/bjr.20160780.
［20］	Guimarães JB, Nico MA, Omond AG, et al. Diagnostic imaging of inflammatory myopathies: new concepts and a radiological approach［J］. Curr Rheumatol Rep, 2019,21（3）:8. doi: 10.1007/s11926⁃019⁃0807⁃z.
［21］	Mohannak N, Pattison G, Hird K, et al. Dysphagia in patients with sporadic inclusion body myositis: management challenges［J］. Int J Gen Med, 2019,12:465⁃474. doi: 10.2147/IJGM.S198031.
［22］	吴小青, 贾岩龙, 余开湖. 皮肌炎/多发性肌炎的磁共振成像研究进展［J］. 临床放射学杂志, 2018,37（4）:716⁃718.
［23］	Albayda J, van Alfen N. Diagnostic value of muscle ultrasound for myopathies and myositis［J］. Curr Rheumatol Rep, 2020,22（11）:82. doi: 10.1007/s11926⁃020⁃00947⁃y.
［24］	Endo Y, Miller TT. Myositis and fasciitis: role of imaging［J］. Semin Musculoskelet Radiol, 2018,22（3）:286⁃298. doi: 10. 1055/s⁃0038⁃1641572.
［25］	Selva⁃O′Callaghan A, Gil⁃Vila A, Simó⁃Perdigó M, et al. PET scan: nuclear medicine imaging in myositis［J］. Curr Rheumatol Rep, 2019,21（11）:64. doi: 10.1007/s11926⁃019⁃0864⁃3.
［26］	Li Y, Zhou Y, Wang Q. Multiple values of 18F⁃FDG PET/CT in idiopathic inflammatory myopathy［J］. Clin Rheumatol, 2017,36（10）:2297⁃2305. doi: 10.1007/s10067⁃017⁃3794⁃3.
［27］	McCann LJ, Garay SM, Ryan MM, et al. Oropharyngeal dysphagia in juvenile dermatomyositis （JDM）: an evaluation of videofluoroscopy swallow study （VFSS） changes in relation to clinical symptoms and objective muscle scores［J］. Rheumatology （Oxford）, 2007,46（8）:1363⁃1366. doi: 10.1093/rheumatology/kem131.
［28］	Oh TH, Brumfield KA, Hoskin TL, et al. Dysphagia in inflammatory myopathy: clinical characteristics, treatment strategies, and outcome in 62 patients［J］. Mayo Clin Proc, 2007,82（4）:441⁃447. doi: 10.4065/82.4.441.
［29］	Azola A, Mulheren R, Mckeon G, et al. Dysphagia in myositis: a study of the structural and physiologic changes resulting in disordered swallowing［J］. Am J Phys Med Rehabil, 2020,99（5）:404⁃408. doi: 10.1097/PHM.0000000000001354.
［30］	Ertekin C, Seçil Y, Yüceyar N, et al. Oropharyngeal dysphagia in polymyositis/dermatomyositis［J］. Clin Neurol Neurosurg, 2004,107（1）:32⁃37. doi: 10.1016/j.clineuro.2004.02.024.

[1]	王媛李志量李锁荆可孙超梁桂熔张寒梅冯素英. 抗p200类天疱疮7例临床及免疫血清学特征分析[J]. 中华皮肤科杂志, 2022, 55(7): 557-561.
[2]	中国医师协会皮肤科医师分会自身免疫病专业委员会 . 【开放获取】环孢素治疗免疫相关性皮肤病专家建议[J]. 中华皮肤科杂志, 2022, 55(6): 471-479.
[3]	申晨陈俊均杨骥胡东艳辛崇美李明. 硬斑病患者180例临床特征及分类探讨[J]. 中华皮肤科杂志, 2022, 55(4): 308-315.
[4]	王召阳陈安薇向欣罗晓燕徐子刚王华马琳. 基于两家儿童医院信息系统的儿童银屑病现状调查[J]. 中华皮肤科杂志, 2022, 55(3): 246-250.
[5]	韩晓锋孙娟邱磊尉莉马琳. 儿童穿通型毛母质瘤29例临床病理特点分析[J]. 中华皮肤科杂志, 2022, 55(3): 196-199.
[6]	吕玲吕小岩. 皮肌炎伴发恶性肿瘤的研究进展[J]. 中华皮肤科杂志, 2022, 55(3): 276-279.
[7]	顾安康张宇马法库孔祥君张理涛. 游泳池肉芽肿56例临床病理分析[J]. 中华皮肤科杂志, 2022, 0(2): 20210180-e20210180.
[8]	邹美熔汪盛. 免疫检查点抑制剂所致皮肤免疫相关不良反应的研究进展[J]. 中华皮肤科杂志, 2022, 0(1): 20201221-e20201221.
[9]	张莹甘璐李思琪李颜宋昊邵雪宝张韡徐秀莲姜祎群曾学思陈浩孙建方. 伴大细胞转化的蕈样肉芽肿24例临床病理及免疫表型分析[J]. 中华皮肤科杂志, 2022, 55(1): 20-26.
[10]	贾韬宋相瑾耿松梅. 自身炎症性皮肤病[J]. 中华皮肤科杂志, 2022, 0(1): 20201253-e20201253.
[11]	陈凤鸣亢寒梅高天文付萌王雷刘玲. 先天性色素痣伴增生性结节10例临床病理分析[J]. 中华皮肤科杂志, 2021, 54(9): 785-789.
[12]	王逸飞耿怡缪秋菊宋昊徐秀莲孙建方. 黏蛋白痣10例临床病理分析[J]. 中华皮肤科杂志, 2021, 54(9): 804-807.
[13]	中国医师协会皮肤科医师分会自身免疫性疾病学组. 环磷酰胺治疗自身免疫性皮肤病中国专家共识[J]. 中华皮肤科杂志, 2021, 54(9): 765-770.
[14]	李婷徐明圆吴飞梁豫琳刘业强. 204例皮角患者组织病理与临床分析[J]. 中华皮肤科杂志, 2021, 54(8): 677-682.
[15]	陈映丹, 黄惠罗帅寒天李亚萍施小六张桂英. 不伴竹节发的不典型迟发Netherton综合征一例[J]. 中华皮肤科杂志, 2021, 54(8): 716-718.

影像技术在皮肌炎诊断和病情评估中的研究进展

Application of imaging techniques in diagnosis and severity assessment of dermatomyositis

PDF

PDF (Mobile)

可视化

摘要/Abstract

引用本文

使用本文

参考文献 30

相关文章 15

Metrics

本文评价

推荐阅读 10