THE APPLICATION OF MAGNETIC RESONANCE IMAGING FOR DIAGNOSTICS OF ACUTE POSTEXERCISE RHABDOMYOLYSIS

Abstract

Introduction. Rhabdomyolysis is destruction syndrome of striated skeletal muscle characterized by myalgia, an increase of creatine phosphokinase level (CPK), serum myoglobin and myoglobulinuria. This review presents the analysis of five cases of acute postexercise rhabdomyolysis happened to militaries, complicated by pigmentary nephropathy with the description of clinical and laboratory studies, magnetic resonance imaging (MRI), electroneuromyographic and morphological features. The purpose of the study is the clinical assessment of MRI for the diagnosis of postexercise rhabdomyolysis. Results. A comparative assessment demonstrated that in the presented clinical cases in the muscle groups with minimal edematous changes, an increase in the MR signal was observed at T2-WISPAIR, as well as in diffusion-weighted images (factor b — 0, 500, 1000), at the same time on all other pulse sequences (including STIR) changes in signal intensity were not detected. Conclusion. There was shown that in mild cases of rhabdomyolysis, the regression of MR manifestations corresponds to a decrease in laboratory parameters of CPK and myoglobin, whereas in severe forms of rhabdomyolysis, the regression of MR manifestations is significantly slowed down relative to laboratory indicators, and in the place of necrosis areas, the foci of degeneration form (hyperintensive on T1 and T2-WI, hypo-intensive on T1-WI-SPIR and T2-WI-SPAIR). Morphologically confirmed the fact of pronounced hemorrhage in the compartment syndrome due to postload rhabdomyolysis (hyperintensive sites on T1-WI and T1-WI-SPIR, iso-, hypointensive on T2-WI, T2-WI-SPAIR).