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International Angiology 2018 August;37(4):293-9

DOI: 10.23736/S0392-9590.18.03943-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

31P-MR spectroscopy in patients with mild and serious lower limb ischemia

Petr SEDIVY 1, 2, Miloslav DROBNY 1, 2, Monika DEZORTOVA 1, Vit HERYNEK 1, Karel ROZTOCIL 3, Helena CERMAKOVA 3, Andrea NEMCOVA 4, Michal DUBSKY 4, Milan HAJEK 1

1 Magnetic Resonance Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; 2 First Faculty of Medicine, Charles University, Prague, Czech Republic; 3 Department of Transplant Surgery, Transplant Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; 4 Department of Diabetes, Diabetes Center, Institute for Clinical and Experimental Medicine, Prague, Czech Republic


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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.


KEY WORDS: Magnetic resonance spectroscopy - Peripheral vascular diseases - Diabetes mellitus - Muscle - Energy metabolism

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