In patients with Duchenne muscular dystrophy (DMD), T1 mapping of the pelvic and thigh muscles can be used as a quantitative biomarker for disease involvement, as well as to evaluate disease severity and motor function.
A prospective cohort study on the topic was conducted among a group of Chinese patients with DMD. Results of the analysis were published in the journal BMC Musculoskeletal Disorders.
The researchers sought to explore the utility of quantitative T1 mapping in detecting the degree of disease involvement among individuals with DMD via a detailed analysis of the hip and thigh muscles, along with its predictive value for establishing patients’ clinical status.
DMD is characterized by irreversible, progressive intramuscular fat infiltration, which, in turn, generates muscle weakness. In patients with DMD, motor function gradually advances from initial gait abnormalities to loss of ambulation and eventually to reliance on a wheelchair. Currently, the disease is incurable, but a comprehensive, accurate evaluation of disease status is critical for the application of appropriate treatment measures that are intended to delay progression and improve quality of life.
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A total of 92 participants with DMD were enrolled in the present study between May 2020 and July 2021. Patient mean age was 8.78±2.06 years (range, 5 to 15 years). Disease distribution and severity were assessed and compared by grading fat infiltration and measuring T1 values of 19 pelvic and thigh muscles on the right side in axial T1-weighted images (T1W1) and T1 maps, respectively.
Clinical evaluations included age, weight, height, body mass index, timed functional tests, NorthStar ambulatory assessment (NSAA) score, wheelchair use, and serum creatine kinase(CK) level.
Results of the study demonstrated that the gluteus maximus had the lowest T1 value, whereas the gracilis muscle had the highest T1 value (P <.001 for both). Per T1W1 scoring, decreases in T1 values were significantly associated with increases in the grade of fat infiltration (P <.001). Further, reduced T1 values were correlated with increases in age, weight, height, timed functional tests, and wheelchair use.
T1 values were also positively associated with NSAA score and CK level (P <.05 for both). Additionally, the T1 value of the gluteus maximus, tensor fascia, vastus medialis, vastus intermedius, vastus lateralis, and adductor was significantly associated with the results of clinical motor tests (P <.05).
The investigators concluded that “T1-mapping can be used as a quantitative biomarker for disease involvement, further assessing [a patient’s] disease severity and predicting motor function in DMD.”
Peng F, Xu H, Song Y, et al. Utilization of T1-mapping for the pelvic and thigh muscles in Duchenne muscular dystrophy: a quantitative biomarker for disease involvement and correlation with clinical assessments. BMC Musculoskelet Disord. 2022;23(1):681. doi:10.1186/s12891-022-05640-y