진행성 근육 질환의 초음파소견

Abstract

PURPOSE: To evaluate the ultrasonographic findings of the progressive muscular disease and to correlate the ultrasonographic findings with their clinical functional level and muscle biopy findings. MATERIALS & METHODS: Twenty six children with progressive muscular disease, including 24 boys and 2 girls, were examined by ultrasonography. The ultrasonography were done with 7 MHz transducer and were made over the thigh and calp in both longitudinal and transverse direction. This ultrasonographic findings were classified on a four-point scale according to the involved muscular echogenicity and distinctivity of the cortical echogenicity (Grade I; normal, Grade II; increased muscular echogenicity with distinct cortical bone-echogenicity, Grade III; marked increased muscular echogenicity and reduced cortical bone-echogenicity, Grade IV; very strong muscle echogenicity with complete loss of cortical bone-echogenicity). This classified ultrasonographic findings were compared with the clinical functional level by Swinyard and muscular biopsy findings(Grade I; normal, Grade II; some invasion of fat or cormective tissue, Grade III;disruption of muscle fascicles, Grade IV;infiltration over 50% by fat and connective tissue). RESULTS: At the femoral muscle, realtively early stage group (stage1~3) members (n=12) show 9 cases of grade I, 2 cases of grade II, 1 grade III ultrasonogram and relatively more progressive group (stage4~8) members (n=14) show no case of grade I, 2 cases of grade II, 12 cases of grade III ultrasonogram. At the calp muscle, relatively early stage group(stage1~3) members(n=12) show 6 cases of grade I, 6 cases of grade II ultrasonogram and relatively more progressive group (stage4~8) members(n=14) show 11 cases of grade II and 3 cases of grade III ultrasonogram. There is some linear correlation between muscle biopsy grade and ultrasonographic grade (Fig.3). CONCLUSION: There is a close correlation between ultrasonographic finding and muscle biopsy findings in progressive muscular disease. Also there is a close correlation between ultrasonographic findings and clinical functional level at the femoral and calp muscle groups in muscular disease, especially progressive musular dystrophy. Thus ultrasonogram over the femoral or calp muscle can be used as the noninvasive diagnostic method for the predictor of the functional level in the progressive muscular disease.