Analysis of MRI in the diagnosis of myositis

Idiopathic inflammatory myopathy IIM (generally called Myositis) isa rare but serious condition characterised by the presence of skeletal muscleinflammation, causing muscle weakness and disability (Targoff 1998,Karpati and Hilton-Jones 2001, Harris-Love 2003, Sultan et al 2002, Plotz1989). There is no 'Gold standard' test for diagnosing this disease whichmakes it challenging for physician. However, tests such as; muscle electromyogrphy(EMG), Creatine kinase serum (CPK) and biopsy are the best incurrent practice (Harris-Love 2003, Sultan et al 2002, Plotz 1989). Allprevious tests have their limitations. MR imaging has been successfully usedto evaluate patients suspected of having IIM. MR images are reportedfollowing visual analysis by radiologists. In this research, two approacheswere used to improve the diagnosis of Myositis with the aid of MRI:First: by using IDL PC software (In-house software developed toquantitatively analyse MR images and categorises its pixels according totheir values). MR images and data were collected retrospectively.Second: by altering MR pulse sequences to achieve the optimum sequencesfor diagnosing myositis (data collected prospectively).Method:In this study, Quality Control tests were obtained and checked for all scannersused, Radiologists subjectivity in reporting MR images was tested and PCsoftware reliability was assessed prior to commencing the main study tominimise error.Retrospective study:43 patients were retrieved from the archiving system in a ITesla scanner andanalysed using IDL PC software. The result was compared with other clinicaltests such as biochemistry blood tests and biopsies.68 patients were retrieved from the archiving system in a 1.5T scanner andanalysed using IDL PC software. The results were also compared with otherclinical tests.Prospective study:15 patients were scanned with an 'optimised protocol' of MR pulse sequence.Contrast-to-Noise ratio (CNR) was to be measured, calculated and thencompared with 'reference protocol' which was used as routine practice.Consequently, these two approaches were evaluated and compared withevidence of MRJ advantages in diagnosing myositis from the literature.Results:The study shows that IDL is consistent and gave reliable output readings in bothavailable operating options (Manual- Automatic). Intra/ Inter observer reliabilitytests were (Manual .754, .998) (Automatic 1.0)The retrospective study suggested new techniques such as; PD with Fat.Satwhich provide excellent tissue contrast for myositis patients.Conclusion:IDL software is a promising solution in computer-aid programmes. Using suchprogrammes can minimise human error. In addition, new MR pulse sequencesuch (PD+FS) could be used for early diagnosis of myositis, as it provideshelpful diagnosis information for Radiologists.

Level dc:type.qualificationlevel

Doctoral (Level 8)

Year dc:date.issued

2007

Author dc:creator

• Al-Nahedh, Y

Language dc:language

en

Identifier

oai:salford-repository.worktribe.com:1337297

OAI identifier oai:identifier

oai:salford-repository.worktribe.com:1337297