Sedivy Petr, Drobny Miloslav, Dezortova Monika, Herynek Vit, Roztocil Karel, Cermakova Helena, Nemcova Andrea, Dubsky Michal, Hajek Milan
Magnetic Resonance Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
First Faculty of Medicine, Charles University, Prague, Czech Republic.
Int Angiol. 2018 Aug;37(4):293-299. doi: 10.23736/S0392-9590.18.03943-3. Epub 2018 Apr 11.
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.
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.
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.
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.
³¹P - 磁共振波谱技术是一种用于全面评估肌肉代谢的技术。本研究的目的是比较通过³¹P - 磁共振波谱在静息和运动状态下测量的轻度和重度下肢缺血患者。
16名非糖尿病轻度外周动脉闭塞性疾病（PAOD）患者、23名患有严重缺血的糖尿病PAOD患者和19名健康对照者，使用配备了与磁共振兼容的自制踏板测力计的3T磁共振系统进行静息和动态³¹P - 磁共振波谱检查。在静息状态下获得磷代谢物与所有³¹P强度总和（Ptot）的信号强度比以及pH值。根据动态磁共振波谱计算磷酸肌酸下降（ΔPCr）、磷酸肌酸的时间恢复常数（τPCr）、运动结束时的pH值（pHend）和线粒体容量（Qmax）。
患有严重缺血的糖尿病PAOD患者在静息（PCr/Pi、βATP/Ptot、pH）和动态（Qmax、pHend、τPCr）参数方面与对照组均存在差异。轻度缺血的PAOD患者仅在Qmax和pHend方面与对照组不同。非糖尿病PAOD患者的静息参数与对照值无差异，但排除静息pH值，两组患者的静息pH值均较高。
静息和动态³¹P - 磁共振波谱相结合可以区分所有三组受试者。另一方面，静息检查足以区分患者组并验证严重缺血情况。
