In Duchenne muscular dystrophy (DMD), respiratory muscle weakness leads to eventual respiratory failure. For this investigation, dynamic MRI was utilized to characterize diaphragm and chest wall dynamics during breathing, and chemical shift-encoded imaging was utilized to assess fatty infiltration in accessory respiratory muscles in 36 individuals with DMD and 12 unaffected controls. For maximal inspirations, individuals with DMD had significantly reduced anterior-posterior chest expansion, and a subgroup with poor respiratory function had decreased diaphragm descent (normalized to height). The expiratory muscles had high levels of fatty infiltration, and muscle fat fraction was correlated with measures of expiratory muscle strength.
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