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This study validated a novel time-efficient coronal view-based muscle MRI protocol and a semiquantitative visual scoring system as a practical alternative for evaluating hereditary (HM) and inflammatory myopathies (IM). Using coronal short tau inversion recovery (STIR) and T1-weighted sequences, we assessed edema and fatty infiltration in 102 subjects, including patients with HM, IM, and healthy controls. To verify diagnostic reliability, a plane-to-plane comparison (coronal vs. axial) was performed in the thigh muscles, demonstrating excellent agreement between visual scores (ICC &gt; 0.9, Kappa &gt; 0.79). Clinically, higher visual fat scores in HM correlated significantly with muscle weakness (p &lt; 0.001) and older age, while higher edema scores in IM correlated with weakness (p = 0.013) and female sex. Histopathologically, MRI fat scores correlated with internal nucleation and Oil Red O staining (p &lt; 0.001), whereas edema scores correlated with fiber necrosis (p &lt; 0.001), regeneration, and interstitial fibrosis (p &lt; 0.001). This novel coronal protocol offers a validated, high-throughput alternative enabling wide anatomical coverage in significantly less time, with visual scores that strongly correlate with clinical status and histopathology, supporting its utility as a biomarker for disease monitoring.<\/jats:p>","DOI":"10.1177\/22143602261460631","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:25:57Z","timestamp":1781137557000},"page":"1533-1545","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Time-efficient coronal MRI reflects clinical and pathological features of myopathies"],"prefix":"10.1177","volume":"13","author":[{"given":"Gin Hoong","family":"Lee","sequence":"first","affiliation":[{"name":"New Taipei Municipal TuCheng Hospital (Built and Operated By Chang Gung Medical Foundation)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Chao","family":"Chao","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5544-8302","authenticated-orcid":false,"given":"Hsin-Chieh","family":"Huang","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsin-Yi","family":"Huang","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Yu","family":"Su","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Te-Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital"},{"name":"National Taiwan University Hospital Hsin-Chu Branch"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Chao","family":"Yang","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany Ting-Fang","family":"Shih","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Tsang","family":"Hsieh","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital"},{"name":"National Taiwan University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4707-1861","authenticated-orcid":false,"given":"Hsueh-Wen","family":"Hsueh","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital"},{"name":"National Taiwan University Hospital Hsin-Chu Branch"},{"name":"National Taiwan University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-016-0667-0"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12144769"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-018-0732-6"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24447"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2009.02765.x"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2004.03.008"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27382"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13250"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/tomography10090106"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1604007"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.24917"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008811"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-015-3783-3"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00242-2"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24569"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211468"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2017.09.016"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-017-1219-y"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(03)00211-8"},{"key":"e_1_3_7_21_2","volume-title":"Muscles Testing and Function with Posture and Pain - Fifth Edition","author":"Kendall Fp KME","year":"2005","unstructured":"Kendall Fp KME, Geise Provance P, McIntyre Rodgers M, et al. 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