BACKGROUND: 31P-MR spectroscopy is a technique for undertaking a comprehensive evaluation of muscle metabolism. The goal of this study was to compare patients with mild and severe lower limb ischemia measured by 31P-MR spectroscopy at rest and during exercise. METHODS: Sixteen non-diabetic mild peripheral arterial occlusive disease (PAOD) patients, 23 diabetic PAOD patients with severe ischemia and 19 healthy controls were examined by rest and dynamic 31P-MR spectroscopy with a 3T MR system equipped with an MR-compatible home-made pedal ergometer. Signal intensity ratios of phosphorous metabolites to the sum of all 31P intensities (Ptot) and pH were obtained at rest. The PCr drop (ΔPCr), time recovery constant of PCr (τPCr), pH at the end of the exercise (pHend), and mitochondrial capacity (Qmax) were calculated from dynamic MR spectra. RESULTS: Diabetic PAOD patients with severe ischemia differed from controls in both rest (PCr/Pi, βATP/Ptot, pH) and dynamic (Qmax, pHend, τPCr) parameters. PAOD patients with mild ischemia differed from controls only in Qmax and pHend. Rest parameters of the nondiabetic PAOD patients did not differ from control values excluding rest pH which was higher in both patient groups. CONCLUSIONS: A combination of rest and dynamic 31P-MR spectroscopy can distinguish among all three groups of subjects. On the other hand, examination at rest is sufficient for differentiation between patient groups and verification of severe ischemia.

1st Faculty of Medicine Charles University Prague Czech Republic

Department of Diabetes Diabetes Center Institute for Clinical and Experimental Medicine Prague Czech Republic

Department of Transplant Surgery Transplant Center Institute for Clinical and Experimental Medicine Prague Czech Republic

Magnetic Resonance Unit Department of Diagnostic and Interventional Radiology Institute for Clinical and Experimental Medicine Prague Czech Republic

Citace poskytuje Crossref.org

Skeletal Muscle 31P MR Spectroscopy Surpasses CT in Predicting Patient Survival After Liver Transplantation

In Vitro 31P MR Chemical Shifts of In Vivo-Detectable Metabolites at 3T as a Basis Set for a Pilot Evaluation of Skeletal Muscle and Liver 31P Spectra with LCModel Software