Research Article

Multi-Parametric Quantitative MRI in the Early Differential Diagnosis of Ambulatory Children With Duchenne Muscular Dystrophy and Becker Muscular Dystrophy

Fei Peng

orcid.org/0009-0002-6917-0895

Department of Radiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China

Department of Radiology, Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China

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Huayan Xu,

Huayan Xu

orcid.org/0000-0001-7276-6142

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Ting Xu,

Ting Xu

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Ke Xu,

Ke Xu

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Xiaotang Cai,

Xiaotang Cai

Department of Pediatrics Neurology, West China Second University Hospital, Sichuan University, Chengdu, China

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Jiaoyang Li,

Jiaoyang Li

Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China

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Heng Zhao,

Corresponding Author

Heng Zhao

[email protected]

orcid.org/0000-0001-6549-4644

Department of Radiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China

Correspondence:

Heng Zhao ([email protected])

Yingkun Guo ([email protected])

Wenhong Liu ([email protected])

Limin Liu ([email protected])

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Wenhong Liu,

Corresponding Author

Wenhong Liu

[email protected]

Department of Radiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China

Correspondence:

Heng Zhao ([email protected])

Yingkun Guo ([email protected])

Wenhong Liu ([email protected])

Limin Liu ([email protected])

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Yingkun Guo,

Corresponding Author

Yingkun Guo

[email protected]

orcid.org/0000-0001-8437-9887

Correspondence:

Heng Zhao ([email protected])

Yingkun Guo ([email protected])

Wenhong Liu ([email protected])

Limin Liu ([email protected])

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Limin Liu,

Corresponding Author

Limin Liu

[email protected]

Department of Ultrasound, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China

Correspondence:

Heng Zhao ([email protected])

Yingkun Guo ([email protected])

Wenhong Liu ([email protected])

Limin Liu ([email protected])

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Fei Peng,

Fei Peng

orcid.org/0009-0002-6917-0895

Department of Radiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China

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Huayan Xu,

Huayan Xu

orcid.org/0000-0001-7276-6142

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Ting Xu,

Ting Xu

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Ke Xu,

Ke Xu

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Xiaotang Cai,

Xiaotang Cai

Department of Pediatrics Neurology, West China Second University Hospital, Sichuan University, Chengdu, China

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Jiaoyang Li,

Jiaoyang Li

Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China

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Heng Zhao,

Corresponding Author

Heng Zhao

[email protected]

orcid.org/0000-0001-6549-4644

Department of Radiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China

Correspondence:

Heng Zhao ([email protected])

Yingkun Guo ([email protected])

Wenhong Liu ([email protected])

Limin Liu ([email protected])

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Wenhong Liu,

Corresponding Author

Wenhong Liu

[email protected]

Department of Radiology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China

Correspondence:

Heng Zhao ([email protected])

Yingkun Guo ([email protected])

Wenhong Liu ([email protected])

Limin Liu ([email protected])

Search for more papers by this author

Yingkun Guo,

Corresponding Author

Yingkun Guo

[email protected]

orcid.org/0000-0001-8437-9887

Correspondence:

Heng Zhao ([email protected])

Yingkun Guo ([email protected])

Wenhong Liu ([email protected])

Limin Liu ([email protected])

Search for more papers by this author

Limin Liu,

Corresponding Author

Limin Liu

[email protected]

Department of Ultrasound, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China

Correspondence:

Heng Zhao ([email protected])

Yingkun Guo ([email protected])

Wenhong Liu ([email protected])

Limin Liu ([email protected])

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First published: 04 March 2025

https://doi.org/10.1002/jmri.29755

Funding: This work was supported by the Hunan Provincial Natural Science Foundation of China (2023JJ30552, 2025JJ81045).

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ABSTRACT

Background

Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD), the most common dystrophinopathies, require distinct treatments. Corticosteroids are effective for DMD but less so for BMD. Early diagnosis can improve DMD outcomes and prevent BMD overtreatment. However, differentiating them in younger children with mild symptoms is challenging due to overlapping features.

Purpose

To evaluate the performance of multi-parametric quantitative MRI (qMRI) in early differentiation between BMD and DMD, particularly among younger patients in the mild disease stage.

Study Type

Prospective.

Subjects

121 DMD males (mean age 8.5 ± 1.6 years), 28 BMD males (9.7 ± 3.3 years), and 26 male healthy controls (HCs) (9.4 ± 2.7 years).

Field Strength/Sequence

3.0T/3-point Dixon (fast-spin-echo), T1-mapping (modified-Look-Locker-inversion-recovery), and T2-mapping (balance-steady-state-free-precession).

Assessment

qMRI measurements (fat fraction [FF], T1, and T2) in 18 pelvic and thigh muscles were conducted. A linearized NorthStar ambulatory assessment (NSAA) score was used to evaluate the function status, with a mild functional decline stage defined as a score of 76–100.

Statistical Tests

Mann–Whitney test, Kruskal–Wallis test, and Receiver operating characteristic curves. A P-value < 0.05 was considered statistically significant.

Results

In all subject groups, DMD exhibits significantly higher FF and T2 and lower T1 compared to BMD. The max differences in mean FF, T1, and T2 was 45.29%, 543 ms, and 31.0 ms, respectively. Overall, the area under curve (AUC) values for FF surpassed those for T2 and T1 in the majority of muscles. In the mild subgroup below 10 years old, DMD had significantly higher FF and T1 than BMD. The combination of FF and T1 in gluteus medius, rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, and adductor magnus achieved higher AUCs (0.816–0.957) than FF (0.773–0.862) or T1 (0.701–0.819) in differentiating the two subgroups.

Data Conclusion

Multi-parametric qMRI demonstrates potential as an effective tool for early differentiation between DMD and BMD.

Evidence Level

Technical Efficacy

Stage 3

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Volume62, Issue2

August 2025

Pages 457-467

Multi-Parametric Quantitative MRI in the Early Differential Diagnosis of Ambulatory Children With Duchenne Muscular Dystrophy and Becker Muscular Dystrophy

ABSTRACT

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Evidence Level

Technical Efficacy

References

References

Information

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Multi-Parametric Quantitative MRI in the Early Differential Diagnosis of Ambulatory Children With Duchenne Muscular Dystrophy and Becker Muscular Dystrophy

ABSTRACT

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Evidence Level

Technical Efficacy

References

References

Related

Information