Contrast of muscle magnetic resonance imaging and pathological findings of muscle tissue in patients with anti-aminoacyl transfer RNA synthetase antibodies

Methods: Patients with idiopathic inflammatory myopathies (IIMs) diagnosed using the 2017 EULAR/ACR classification criteria in our university between 2005 and 2020 were retrospectively reviewed. IIMs were subclassified into the anti-ARS syndrome (ASSD), immune-mediated necrotizing myositis (IMNM), Dermatomyositis DM and others. Fat-suppressed T2-weighted MRI and muscle biopsy specimens were assessed in IIMs followed by the comparison among the four subgroups. MRI findings were available for 62 patients and histopathological findings were available for 27 patients. Perifascicular atrophy or necrosis in the muscle tissues from the patients with IIM was more frequently observed in patients with subcutaneous and fascial high signal intensity (HSI) on MRI than those without. Four-group comparison among ASSD, IMNM, DM and others revealed HSI in fasciae on MRI was more frequently observed in patients with ASSD and DM than others. Perifascicular atrophy or necrosis in muscle tissues was more frequently observed in patients with ASSD than in others. Patients with ASSD had distinct MRI features compared with anti-ARS negative patients. The fascial high signal intensity on MRI may reflect distinctive pathological features of muscles.