Strain sonoelastography of inflammatory myopathies: comparison with clinical examination, magnetic resonance imaging and pathologic findings

Objective: To evaluate strain sonoelastography (SSE) in patients with inflammatory myopathies (IM) compared with clinical examination, MRI and pathologic findings. Methods: 18 lesions from 17 consecutive patients with IM (5 males and 12 females; mean age, 41.2 years; range, 11-67 years) were assessed with SSE after MRI. The ratio of strain in the target muscle (A) and a nearby normal muscle (B), defined as the strain index value (SR) (B/A), was calculated automatically. Elastograms were assigned an elasticity score according to the degree and distribution of strain induced by manual compression. Ultrasonography and MRI were analyzed in conjunction with clinical information, biochemical data, final clinical diagnosis and grading of pathology. Correlations between SR and qualitative analyses of MRI and ultrasonography, elasticity score, biochemical data and final clinical diagnosis were analyzed using Pearson's correlation coefficient. Results: The SR of the target muscles was high in patients with IM (mean 3.14; range, 0.95-5.93 +/- 1.42). The correlations between SR and pathologic grading and elasticity score were statistically significant (p < 0.05). There was no significant agreement between SR and other clinical and radiologic parameters. Conclusion: Muscle hardness, as semi-quantitatively measured by SSE, was increased in cases of IM. The correlation between the SR and the pathologic grading suggests that SSE could be an important tool in not only the diagnosis of but also in measuring the degree of muscular inflammation. Advances in knowledge: This work describes a correlation between tissue elasticity and pathology in IM