Muscle MRI of classic infantile pompe patients: Fatty substitution and edema-like changes

Muscle Nerve. 2017 Jun;55(6):841-848. doi: 10.1002/mus.25417. Epub 2017 Feb 9.

Abstract

Introduction: The aim of this study was to evaluate the muscle MRI pattern of 9 patients (median age: 6.5 ± 2.74 years) affected by classic infantile-onset Pompe disease who were treated with enzyme replacement therapy.

Methods: We performed and qualitatively scored T1-weighted (T1-w) sequences of the facial, shoulder girdle, paravertebral, and lower limb muscles and short-tau inversion recovery (STIR) sequences of the lower limbs using the Mercuri and Morrow scales, respectively.

Results: On T1-w images, mild (grade 1) or moderate (grade 2) involvement was found in the tongue in 6 of 6 patients and in the adductor magnus muscle in 6 of 9. STIR hyperintensity was detected in all areas examined and was categorized as limited to mild in 5 of 8 patients.

Conclusions: On T1-w sequences, mild/moderate adipose substitution in the adductor magnus and tongue muscles was documented. STIR edema-like alterations of thigh and calf muscles are novel findings. Correlations with biopsy findings and clinical parameters are needed to fully understand these findings. Muscle Nerve 55: 841-848, 2017.

Keywords: Pompe disease; STIR; T2; glycogenosis II; infantile-onset Pompe disease; muscle MRI.

MeSH terms

  • Adipose Tissue / diagnostic imaging
  • Child
  • Child, Preschool
  • Edema / diagnostic imaging*
  • Edema / etiology*
  • Female
  • Glycogen Storage Disease Type II / complications*
  • Glycogen Storage Disease Type II / pathology*
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging*
  • Male
  • Muscle, Skeletal / diagnostic imaging*