"NT11275" Dotaz Zobrazit nápovědu
Závěrečná zpráva o řešení grantu Interní grantové agentury MZ ČR
1 svazek : ilustrace, tabulky ; 30 cm
The project pursues two main goals. In the methodological part, the clinical examination of patients using in vivo 31P MR spectroscopy, which is currently not available in the Czech Republic, will be restored. Using this method, it will be possible to non-invasively study the metabolism of muscular (including heart muscle) and hepatic tissues based on the intracellular concentrations of metabolites containing phosphorus (ATP, PCr, etc.). Patients with diabetes and patients with heart disease will participate. The metabolism of skeletal muscle, the liver and heart with respect to clinical state and the applied treatment will be studied at rest and during exercise using an MR-compatible ergometer. Thanks to the non-invasiveness of the method, the diagnostic possibilities will be improved without any invasive interventions and, hence, with greater comfort for the examined patients. In the future the methods should be available for other branches of medicine where this type of examination is required.
Projekt sleduje dva základní cíle. Jednak jde o část metodickou, kdy se obnoví možnosti klinického vyšetřování pacientů pomocí in vivo fosforové MR spektroskopie, které není v současné době v ČR dostupné. Bude tak možné neinvazivně sledovat metabolismus svalové (včetně srdeční) nebo jaterní tkáně na základě intracelulárních koncentrací metabolitů obsahujících fosfor (např. ATP, fosfokreatin). Provedení výpočtů a kalibrací umožní použít metodu pro rutinní klinické vyšetřování svalů, srdce a jater včetně zátěžového testu s použitím ergometru. Prvním souborem nemocných budou pacienti s diabetem, u kterých se bude sledovat metabolismus kosterního svalu a jater v závislosti na klinickém stavu a léčbě, posléze se předpokládá rozšíření na skupinu pacientů s onemocněním srdce. Vzhledem k neinvazivnosti metody dojde ke zlepšení diagnostických možností bez invazivních zásahů a tím i komfortu vyšetření pro pacienty. V budoucnu by měla být metoda dostupná i pro další lékařské obory, které toto vyšetření vyžadují.
The myocardium examination by MR spectroscopy is very challenging due to movements caused by the cardiac rhythm and breathing. The aim of the study was to investigate the influence of breathing on the quantitative measurement of lipid/water ratios in different groups of volunteers and different measuring protocols. We examined the lipid content of myocardium at 3T using the proton single voxel spectroscopy. Three protocols (free breathing, breath hold and the use of respiratory navigator) controlled by ECG were used for the examination of 42 adult volunteers including 14 free divers. Spectra were evaluated using jMRUI software. An average content of lipids in the healthy interventricular septum, gained by all protocols was equal to 0.6 %, which is in agreement with other published data. Based on the quality of examinations and the highest technical success, the best protocol seems to be the one containing a respiratory navigator since it is more acceptable by patients. Based on our results and the literature data we can conclude that MR spectroscopy is able to distinguish patients from controls only if their myocardial lipid content is higher than 1.6 % (mean value of lipids plus two standard deviations).
- MeSH
- dospělí MeSH
- dýchání MeSH
- lidé MeSH
- lipidy analýza MeSH
- magnetická rezonanční spektroskopie metody MeSH
- metabolismus lipidů fyziologie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- myokard metabolismus MeSH
- pilotní projekty MeSH
- plicní ventilace fyziologie MeSH
- protony MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
PURPOSE: Dynamic phosphorus magnetic resonance spectroscopy ((31)P MRS) during and after acute exercise enables the noninvasive in vivo determination of the mitochondrial capacity of skeletal muscle. Nevertheless, the lack of standardization in experimental setups leads to significant variations in published values of maximal aerobic capacity, even in the population of healthy volunteers. Thus, in this study, we aimed to assess the impact of the ergometer type (pneumatic and mechanical resistance construction), radiofrequency (RF)-coil diameter, and different magnetic field strengths (3 and 7 T) on the metabolic parameters measured by dynamic (31)P MRS during a plantar flexion isotonic exercise protocol within the same group of healthy volunteers. METHODS: Dynamic (31)P MRS measurements of the calf muscle in 11 volunteers (mean age, 36 ± 13 yrs; mean BMI, 23.5 ± 2.5 kg/m(2)), on a 3 T MR system with a custom-made mechanical ergometer in the first research laboratory (RL1) and on 3 and 7 T MR systems equipped with a commercial pneumatic ergometer in the second research laboratory (RL2), were performed at three different workloads. RF-coils differed slightly between the sites and MR systems used. The repeatability of the experimental protocol was tested in every setup. The basal concentrations of phosphocreatine (PCr), exercise-induced depletion of PCr (ΔPCr), initial PCr resynthesis rate (VPCr), and mitochondrial capacity (Qmax) were calculated and compared between the research sites and field strengths. RESULTS: High repeatability of the measurement protocol was found in every experimental setup. No significant differences at any workload were found in these metabolic parameters assessed at different magnetic field strengths (3 T vs 7 T), using the same ergometer (in RL2) and a similar RF-coil. In the inter-research laboratory comparison at the same field strength (3 T), but with using different ergometers and RF-coils, differences were found in the concentration of PCr measured at rest and in the drop in PCr signal intensity. These differences translated into difference in the value of mitochondrial capacity at a workload of 15% of maximal voluntary contraction (MVC) force (0.45 ± 0.16 mM/s vs 0.31 ± 0.08 mM/s, in the RL1 and RL2, respectively). CONCLUSIONS: Metabolic parameters measured during exercise challenge by dynamic (31)P MRS do not depend upon the magnetic field strength used. For multicenter studies with different ergometers, it is important to set the same workload, measurement, and evaluation protocols, especially when the effects of very mild exercise (15% MVC) are to be compared. However, a higher workload (24% MVC) decreases the influence of imperfections and intersite differences for the assessed value of maximal mitochondrial capacity.
- MeSH
- bérec fyziologie MeSH
- cvičení fyziologie MeSH
- design vybavení MeSH
- dospělí MeSH
- ergometrie přístrojové vybavení metody MeSH
- fosfokreatin metabolismus MeSH
- isotonická kontrakce fyziologie MeSH
- izotopy fosforu MeSH
- kosterní svaly metabolismus MeSH
- lidé MeSH
- magnetická rezonanční spektroskopie přístrojové vybavení metody MeSH
- magnetické pole MeSH
- mitochondrie metabolismus MeSH
- reprodukovatelnost výsledků MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- MeSH
- bilirubin * MeSH
- biologické markery * analýza MeSH
- C-reaktivní protein * MeSH
- klinické zkoušky jako téma MeSH
- kyseliny mastné omega-3 * aplikace a dávkování farmakologie imunologie terapeutické užití MeSH
- lidé MeSH
- malabsorpční syndromy * MeSH
- nemoci jater * metabolismus terapie MeSH
- nenasycené mastné kyseliny * aplikace a dávkování farmakologie terapeutické užití MeSH
- parenterální výživa * MeSH
- pilotní projekty * MeSH
- zánět * diagnóza patologie terapie MeSH
- žlučové kyseliny a soli * metabolismus MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
The aim of this work was to evaluate the possibility to use in vivo (31)P magnetic resonance spectroscopy (MRS) for the diagnosis of kidney graft dysfunction after transplantation. We examined 68 kidney grafted patients using a 1.5 T MR scanner. (31)P MRS was performed using the 2D-chemical shift imaging method. The patients were divided into 4 groups: acute rejection episode; acute tubular necrosis; late graft dysfunction; or good renal function. We measured the signal intensities of phosphomonoesters (PME), inorganic phosphate (Pi), phosphodiesters (PDE), and α-, β-, γ-adenosine triphosphate (ATP; with contributions of α- and β-adenosine diphosphate) and their ratios. Patients with an acute rejection episodes showed a significantly elevated PME/β-ATP and PDE/β-ATP, PME/Pi, and PDE/Pi signal ratios compared with the control group. The group with acute tubular necrosis had decreased ratios. Patients with late graft dysfunction revealed only an insignificant decrease in PME/Pi and PDE/Pi ratios. We concluded that (31)P MRS was capable of distinguishing the two main causes of graft dysfunction early after transplantation.
- MeSH
- dospělí MeSH
- izotopy fosforu MeSH
- ledviny patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční spektroskopie metody MeSH
- transplantace ledvin MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
