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Muscle MRI guides the diagnosis in neuromuscular diseases (NMDs); however, comprehensive muscle MRI features for <jats:italic>VCP<\/jats:italic> patients have not been reported so far.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We collected muscle MRIs of 80 of the 255 patients who participated in the \u201cVCP International Study\u201d and reviewed the T1-weighted (T1w) and short tau inversion recovery (STIR) sequences. We identified a series of potential diagnostic MRI based characteristics useful for the diagnosis of <jats:italic>VCP<\/jats:italic> disease and validated them in 1089 MRIs from patients with other genetically confirmed NMDs.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Fat replacement of at least one muscle was identified in all symptomatic patients. The most common finding was the existence of patchy areas of fat replacement. Although there was a wide variability of muscles affected, we observed a common pattern characterized by the involvement of periscapular, paraspinal, gluteal and quadriceps muscles. STIR signal was enhanced in 67% of the patients, either in the muscle itself or in the surrounding fascia. We identified 10 diagnostic characteristics based on the pattern identified that allowed us to distinguish <jats:italic>VCP<\/jats:italic> disease from other neuromuscular diseases with high accuracy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Patients with mutations in the <jats:italic>VCP<\/jats:italic> gene had common features on muscle MRI that are helpful for diagnosis purposes, including the presence of patchy fat replacement and a prominent involvement of the periscapular, paraspinal, abdominal and thigh muscles.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00415-023-11862-4","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T10:01:55Z","timestamp":1692612115000},"page":"5849-5865","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Analysis of muscle magnetic resonance 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