This 4‐year longitudinal study was designed to evaluate the clinical usefulness and sensitivity of muscle MRI in detecting fibro‐adipose degeneration in DMD. A total of 26 patients (baseline age: 5-12 years) with genetically proven DMD were longitudinally analyzed with lower limb 3T MRI, force measurements, and functional tests. Semiquantitative (scores) and quantitative MRI (qMRI) analyses were carried out. Permutation and regression analyses according to both age and functional test-outcomes were calculated. Age-related quantitative reference curves of SIRs and MVIs were generated. The results demonstrate that quantitative MRI values of fat infiltration and muscle volumes are sensitive and objective measures, able define the disease progression even after loss of ambulation, and correlate with clinical performances measured with NSAA, 6MWT, Gowers, and 10‐m time.
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