股四头肌31p-MRS对脂质沉积性肌病的诊断及疗效研究

目的 分析脂质沉积性肌病(lipid storage myopathy,LSM)患者静息时、亚极限运动后及治疗前后股四头肌31磷-磁共振波谱成像(31P-MRS)表现,并探讨31P-MRS对LSM的诊断及疗效价值.资料与方法 对经肌肉活检证实为LSM的9例患者行静息时、亚极限运动后即刻、5 min、10 min和15 min时31P-MRS成像.所有患者经强的松及左卡尼汀治疗后2～4个月(平均2.2个月)后再次行静息状态及亚极限运动后动态31P-MRS成像.对31P-MRS数据进行后处理,获得静息时磷酸肌酸(PCr)、无机磷(Pi)、Pi与三磷酸腺苷之比(Pi/ATP)、Pi/PCr、PCr/ATP、pH、二磷酸腺苷(ADP)、磷酸化能力(PP)和线粒体ATP生成率与线粒体最大产能量之比(Q/Vmax);运动后PCr生成率的速度常数( KPCr)、PCr最初生成率(ViPCr)和线粒体最大产能量(Vmax)等衡量线粒体功能的参数.并将9名年龄匹配的、未经专业体育训练的志愿者作为对照组与病变组静息时、亚极限运动后各项数据相对比.采用配对t检验比较分析病变组与对照组之间、病变组治疗前后的差别,所有数据用SPSS 13.0进行统计分析.结果 (1)治疗前病变组与对照组对比,将出现静息状态代谢物PCr、PCr/ATP、ADP静息状态指标1/PP及运动后指标ViPCr、KPCr、Vmax减小,经统计学分析差异有统计学意义.其他指标差异无统计学意义.(2)病变组治疗前后比较将出现静息状态代谢物ADP及运动后指标Vmax、Vi Pcr、KPcr减小,提示ADP及运动后参数更敏感.静息状态代谢物PCr、PCr/ATP及Pi、Pi/ATP无明显异常.结论 31P-MRS通过运动前后多种参数判断肌肉能量代谢变化、线粒体功能及氧化PP,对LSM的诊断及疗效评估具有重要价值.     

骨肉瘤的31P磁共振波谱观察

目的 利用31P磁共振波谱(MRS)在体分析骨肉瘤与正常骨骼、肌肉组织磷脂代谢特点,探讨31PMRS结合常规MRI在骨肉瘤定性诊断中的价值.资料与方法 对31名健康自愿者的33个部位、18例骨肉瘤行常规MRI与31P MRS检测.对两组各代谢物比值行独立样本t检验,分析骨肉瘤组织细胞膜磷脂代谢指标磷酸单酯(PME)/β-三磷酸腺苷(β-ATP)、磷酸二酯(PDE)/β-A11P等比值变化特点,组织能量磷酸肌酸(PCr)/总31P代谢物(T31P)、ATP/T31P、无机磷(Pi)/β-ATP及细胞内pH值变化特点.结果 骨肉瘤组PME/[β-ATP、Pi/β-A1甲、PDE/β-ATP、PCr/T31P、低能磷酸盐(LEP)/T31P、ATP/T31P、PCr/β-ATP、(PCr+ATP)/Pi及pH值均数分别为1.08±0.19、0.85±0.40、0.98±0.38、0.28±0.09、0.30±0.07、0.42±0.09、2.75±1.25、9.45±3.84、7.35±0.24,对照组各比值均数分别为0.07±0.06、0.34±0.12、0.43±0.26、0.43±0.03、0.10±0.03、0.46±0.03、3.63±0.65、24.53±10.14、7.06±0.08,除ATPP/T31P外,其余比值与对照组均存在明显差异(P值均<0.01).对MRI征象分析结果提示:单独依靠MRI对骨肉瘤符合率为12/18例,而结合31P MRS结果,诊断符合率为16/18例.结论 骨肉瘤组细胞膜磷脂代谢指标较对照组明显升高,高能磷酸盐显著降低,细胞内pH值轻度升高.结合常规MRI,这些特征性改变有利于对骨肉瘤病变的早期诊断和治疗监测.     

3 T磁共振动态磷谱对糖耐量异常患者骨骼肌线粒体功能的在体研究

目的用3 T磁共振动态磷谱技术(31P-MRS)在体无创性评价糖耐量异常(IGT)患者骨骼肌线粒体的功能。资料与方法对16例IGT患者和10名年龄、性别、体重指数(BMI)匹配的正常自愿者骨骼肌进行动态31P-MRS分析,对磷酸肌酸(PCr)、无机磷(Pi)、三磷酸腺苷(α-,β-,和γ-ATP)的半绝对定量分析,同时计算ADP、Pi/PCr、细胞内pH值及恢复期PCr、ADP起始恢复速率。分析静息、运动及恢复期两组受试者骨骼肌能量代谢特点以及线粒体功能状况。结果 IGT组PCr、β-ATP含量各期均低于对照组;ADP均高于对照组;恢复期,IGT组PCr、ADP的初始恢复速度明显低于对照组。Pi、Pi/PCr、pH值两组变化趋势相同,组间无差异。结论 IGT患者的骨骼肌基础能量代谢率降低,骨骼肌线粒体氧化磷酸化功能受损。     

31P MR波谱在骨恶性肿瘤与炎症鉴别中的应用

目的 探讨活体31P MR波谱(31P MRS)在骨恶性肿瘤与炎症鉴别中的价值.方法 对32名健康志愿者、20例恶性骨肿瘤、22例骨及软组织炎症患者分别行常规X线、MRI与31P MRS 检查,测定波谱中各代谢产物的峰下面积,计算各代谢产物间的比值,并根据无机磷(Pi)相对于磷酸肌酸(PCr)的化学位移测定细胞内pH值.统计学采用单因素方差分析.结果 31P MRS检测发现恶性骨肿瘤组磷酸单酯(PME)/β-三磷酸腺苷(ATP)值(1.24±0.37)明显高于对照组和炎症组(P值均＜0.01);炎症组磷酸二酯(PDE)/β-ATP(2.21±0.37)、Pi/β-ATP(1.46±0.43)明显高于对照组和恶性肿瘤组(P值均＜0.05),但PME/β-ATP(0.19±0.10)值不高;对照组低能磷酸盐(LEP)/总31P代谢物(T31P)(0.10±0.02)、PCr/T31p(0.45±0.03)、ATP/T31P(0.45±0.03)与恶性骨肿瘤和炎症组之间差异有统计学意义(P值均＜0.01);恶性肿瘤组细胞内pH值为7.45±0.16,明显高于正常对照组(7.05±0.06)和炎症组(7.20±0.13)(P值均＜0.01).结论 组织中PME和细胞内pH值的升高对恶性骨肿瘤的诊断有重要意义.MRS技术与常规X线、MRI相结合,有助于临床对恶性骨肿瘤与炎症的鉴别.     

静息状态健康成人腓肠肌3.0T31P-MRS分析

目的 应用3.0T 31P-MRS对不同年龄组左腓肠肌磷代谢物定量分析,评估其磷代谢物特点,并为腓肠肌31P-MRS检查参数优化提供依据.方法 32例健康志愿者,在静息状态下进行31P-MRS单体素扫描,分别显示7个代谢产物波峰,同时计算pH值、PME/β-ATP、PCr/PME、β-ATP/Pi、PME/Pi、PDE/β-ATP相对定量分析.结果 健康成人静息状态下显示7个代谢物.PME、PCr、Pi、总ATP、PCr/PME、PME/Pi青年组和与老年组有统计学差异.中老年组PME、PME/β-ATP、β-ATP/Pi、PME/Pi、PDE/β-ATP男性与女性有统计学差异.结论 3.0T 31P-MRS可无创量化健康成人不同年龄、各组不同性别静息状态腓肠肌磷代谢产物.     

~(31)P MR波谱在扩张性心肌病的临床应用

目的　对扩张性心肌病(DCM)进行MRI和31PMR波谱(31PMRS)研究,观察DCM的形态学改变和心肌细胞能量代谢特点。方法　8例健康志愿者为正常对照组,5例DCM病人作为检测组,进行心脏MRI扫描和31PMRS测定。结果　DCM病人的心肌普遍变薄,左心室射血分数下降,平均为33%;心肌细胞磷酸肌酸/三磷酸腺苷(PCr/ATP)和pH值下降,无机磷/磷酸肌酸(Pi/PCr)上升。结论　DCM的心肌代谢异常与心衰程度相关;MRI和31PMRS能够对DCM的形态学和心肌能量代谢作出初步诊断。     

3T动态磁共振磷谱对正常人骨骼肌线粒体功能的在体研究

目的：运用3T高场强磁共振动态磷谱技术（^31P-MRS）在体评价骨骼肌线粒体能量代谢情况。方法：对20名正常人受试者骨骼肌进行动态31P-MRS采集,后期利用Matlab软件对无机磷（Pi）、磷酸肌酸（PCr）、三磷酸腺苷（ATP）等化合物的峰下面积进行定量分析,分别计算在静止期,运动末期及数个恢复期骨骼肌内高能磷酸化合物的含量,同时计算二磷酸腺苷（ADP）和细胞内PH值,评价磁共振动态磷谱技术对研究骨骼肌线粒体功能的价值。结果：肌肉运动时PCr含量明显降低,Pi、Pi/PCr和ADP升高,恢复期各含磷化合物含量逐渐恢复至静息水平。结论：3T高场强动态磷谱技术可以无创性定量评价骨骼肌线粒体功能,为肌肉的功能影像学提供客观证据,为以后客观研究肌肉相关疾病提供了理想的方法。     

31P-MRS在评估肝硬化及其分级中的价值

目的 探讨31P-磁共振波谱(MRS)无创评估肝硬化及其分级的价值.资料与方法 分别对53例肝硬化患者及28名正常对照组进行单体素31P-MRS扫描,计算肝细胞内pH值(pHi)、磷酸单酯(PME)、磷酸双酯(PDE)、无机磷(Pi)、磷酸肌酸(PCr)、γ-ATP、β-ATP、α-ATP、PME/ATP、Pi/ATP、PCr/ATP、PME/PDE、PME/Pi、PDE/Pi、PDE/ATP比值和低能磷酸盐(LEP)等代谢指标.探讨以上各参数在肝硬化及其Child-Pugh分级中的异同.结果 在肝硬化组,PME、PME/ATP、PME/PDE及PME/Pi均大于正常对照组(P<0.05);而Pi则相反(P=0.023;t=2.340).肝硬化Child-Push分级A、B、C级的PME分别为424.23±127.74、468.32±156.10、497.52±169.84,Pi分别为418.02±108.29、353.80±98.81、302.11±74.37,PME/Pi分别为1.03±0.45、1.41±0.59、1.82±0.62,均存在统计学意义(P值分别为0.047、0.038、0.042;F值分别为3.425、4.489、3.811),而其他代谢物在肝硬化及其分级中差异无统计学意义(P>0.05).结论 肝硬化时PME相关参数明显升高,PME、Pi和PME/Pi可对肝硬化的程度进行评估.     

3.0T31P-MRS对骨与软组织肿瘤的诊断价值

目的 探讨超高场31P-MRS对骨与软组织肿瘤的成像特点.方法 对病理证实的骨与软组织肿瘤41例用磷表面线圈进行31P-MRS分析,测量波谱中各代谢产物的峰下面积,分别以三磷酸腺苷β峰(β-ATP)、三磷酸核苷(NTP)、磷酸肌酸(Pcr)为参照计算各代谢产物的相对比值,根据无机磷(Pi)相对于Pcr化学位移的变化计算细胞内pH值,进行相对定量分析.根据峰下面积计算各代谢产物与β-ATP、三磷酸核苷(NTP=ATP+Pi+Pcr)、Pcr的相对值PME/β-ATP、PDE/β-ATP、β-ATP/Pi、PME/NTP、PDE/NTP、Pcr/Pi及Pcr/PME.并运用SPSS11.5 for Windows软件包进行统计学处理,采用多个独立样本的非参数检验.结果 良、恶性肿瘤组的Pcr/PME、PME/NTP较对照组均有显著性差异(P<0.05).良、恶性肿瘤组PME/β-ATP、PME/NTP的差异有显著性意义(P<0.05).与正常组比较,良、恶性肿瘤组的PME和PDE及Pi峰升高,Pcr峰降低.结论 31P-MRS测得的Pcr/PME、PME/NTP与骨、软组织肿瘤相关,PME/β-ATP、PME/NTP在骨与软组织肿瘤的诊断和鉴别诊断中发挥重要的作用.     

MRI对Duchenne肌营养不良的诊断价值

目的 探讨MRI对Duchenne肌营养不良的诊断价值.方法 收集确诊为Duchenne肌营养不良的男性患儿64例,行盆底(62例)、大腿(62例)、小腿(59例)(共692组肌群)MRI检查,轴位T1WI、T2 WI、SPIR及冠位T2 WI扫描.由2名高年资医生独立重点观察:(1)肢体肥大或萎缩;(2)病变肌肉对称性;(3)病变肌肉累及分布;(4)MRI信号特点(脂肪浸润或炎性水肿);(5)9例治疗后复查改变.结果 (1)肢体肥大者17例(26.56％),萎缩者12例(18.75％).(2)4例(6.25％)两侧肌群累及不对称,余肌群受累基本对称.(3)①盆肌:臀大肌受累87.10％,盆底收肌67.74％(x2=6.643,P=0.010).②大腿:股四头肌82.26％,股二头肌75.81％,半腱肌62.90％,半膜肌80.65％,缝匠肌69.23％,股薄肌22.58％(x2=67.075,P=0.000).③小腿:胫骨前肌23.73％,胫骨后肌32.20％,腓肠肌81.36％,比目鱼肌57.63％(x2=48.218,P=0.000).上述肌群均表现有脂肪浸润共352组(352/692,50.87％).其中,发现炎性水肿者203组(203/352,57.67％).≥50％伴有炎性水肿肌群见于臀大肌、股四头肌、胫骨前肌、胫骨后肌和比目鱼肌.(4)9例患者经2～5年治疗复查,MRI变化不一致.结论 MRI对Duchenne肌营养不良的检查诊断有重要作用.下肢肌肉改变应重点观察大肌群如臀大肌、股四头肌、半膜肌及腓肠肌等.     

Exertional heatstroke and muscle metabolism: an in vivo 31P-MRS study.

An impairment of muscle energy metabolism has been suggested as a predisposing factor for, as well as a consequence of exertional heatstroke (EHS). Thirteen young men were investigated 6 months after a well-documented EHS using 31Phosphorus Magnetic Resonance Spectroscopy (31P-MRS). The relative concentrations of ATP, phosphocreatine (PCr), inorganic phosphate (Pi), phosphomonoesters (PME), and the intracellular pH (pHi) were determined at rest, during a graded standardized exercise protocol (360 active plantar flexions) and during recovery. Also the leg tissue blood flow was determined by venous occlusion plethysmography during the MRS procedure. Sixteen age-matched healthy male volunteers served as control group. In resting muscle, there were no significant differences between the groups as regards pHi, Pi/PCr, and ATP/PCr+Pi+PME ratios. During steady state exercise conditions, effective power outputs were similar for both groups at each level of exercise: 20, 35, and 50% of maximal voluntary contraction (MVC) of the calf muscle. No significant differences were shown between the two groups in Pi/PCr, pHi, or changes of leg blood flow at each level of exercise. At 50% MVC, Pi/PCr was 0.48 +/- 0.08 vs 0.47 +/- 0.05 (P = 0.96), pHi was 6.94 +/- 0.03 vs 6.99 +/- 0.02, respectively (P = 0.13). Finally, the rate of PCr resynthesis during recovery was not significantly different between the two groups: t1/2 PCr = 0.58 +/- 0.07 vs 0.50 +/- 0.05 min, respectively (P = 0.35). Therefore, no evidence of an impairment of muscle energy metabolism was shown in the EHS group during a standardized submaximal exercise using 31P-MRS performed 6 months after an EHS.     

Muscle high-energy metabolites and metabolic capacity in patients with heart failure

OKITA, K., K. YONEZAWA, H. NISHIJIMA, A. HANADA, T. NAGAI, T. MURAKAMI, and A. KITABATAKE. Muscle high-energy metabolites and metabolic capacity in patients with heart failure. Med Sci. Sports. Exerc., Vol. 33, No. 3, 2001, pp. 442-448. Background: Various abnormalities in skeletal muscle have been demonstrated by biopsy in patients with chronic heart failure (CHF). In mammalian muscles, high-energy metabolite composition at rest (HEMC) provides data on important metabolic characteristics; however, the significance of HEMC has not been clarified in patients with CHF. Therefore, we investigated HEMC in normal subjects and patients with CHF and examined its relation to muscle metabolic capacity and exercise tolerance. Methods: High-energy metabolites (phosphocreatine (PCr), inorganic phosphate (Pi), and ATP) in resting calf muscle were measured by 31P-magnetic resonance spectroscopy (31P-MRS), and ratios of Pi to PCr, Pi to ATP, and PCr to ATP were calculated in 34 patients with CHF and 13 age- and size-matched normal subjects. Muscle metabolism was evaluated during local exercise of unilateral plantar flexion by 31P-MRS. Metabolic capacity was estimated by the rate of PCr breakdown in relation to the workload. Systemic exercise capacity was evaluated by a bicycle ergometer. Results: The ratio of PCr to ATP was significantly increased in patients with CHF compared with controls (3.06 +/- 0.43 vs 2.72 +/- 0.36, P < 0.05) and was significantly correlated with metabolic capacity (r = -0.37, P < 0.01) and with peak oxygen uptake (r = -0.45, P < 0.01). There was a significant correlation between metabolic capacity and peak oxygen uptake (r = 0.53, P < 0.001). Conclusion: HEMC was altered in patients with CHF, and this change was related to metabolic capacity and exercise capacity. These findings provide new insight into the mechanism of impaired muscle metabolism in CHF.     

Phosphorus 31-magnetic resonance spectroscopic studies of animal liver after extracorporeal shock wave lithotripsy]

The technique of magnetic resonance spectroscopy has been developed, and the study of high-energy phosphate metabolites in the liver using phosphorus 31 magnetic resonance spectroscopy (31P-MRS) has been reported in humans and animals, but few studies have used 31P-MRS for the evaluation of extracorporeal shock wave lithotripsy (ESWL) of the liver. In this study, 31P-MRS was used to evaluate the metabolic changes in hamster liver after ESWL and histological correlation was performed. Syrian golden hamsters were anesthetized and shock waves were irradiated to the left side of the liver. Hamsters were irradiated by LITHOSTAR-PLUS (SIEMENS) at a voltage of 19 KV. 31P-MRS was studied by JNM-GSX model 270 (6.34 Tesla). Typical peaks of 31P-spectra of hamster liver showed a tendency for PDE/beta-ATP, alpha-ATP/beta-ATP and gamma-ATP/beta-ATP to decrease among the irradiated group compared with the control group. However, there were no significant differences in PME/Pi, beta-ATP/Pi or (alpha-ATP-beta-ATP)/beta-ATP between the control group and irradiated group. With regard to intracellular pH and PDE/beta-ATP, a decreasing tendency was noted in the irradiated groups (p less than 0.05). There was no difference in the signal intensity of T1WI and T2WI on 1H-MRI, between these two groups. Pathologically, the irradiated group showed minor hemorrhage and edema in the liver, and subcapsular hematoma. The results obtained from 31P-MRS clearly showed the metabolic changes and were correlated well with the histological findings, but MRI was not capable of providing close visualization of post-ESWL liver damage.(ABSTRACT TRUNCATED AT 250 WORDS)     

磁共振动态磷谱对正常人骨骼肌运动状态功能的定量研究

目的用磁共振动态磷谱技术(31P-MRS)无创性在体评价骨骼肌的功能。资料与方法对10名成年人和6名青少年受试者骨骼肌进行动态31P-MRS分析,对磷酸单酯(PME)、无机磷(Pi)、磷酸二酯(PDE)、磷酸肌酸(CP)、γ-ATP、α-ATP和β-ATP进行半绝对定量分析,同时计算二磷酸腺苷(ADP)和线粒体内氧化磷酸化潜能(PP)以及细胞内镁离子的浓度。分析在静息期、运动期和恢复期两组受试者能量代谢特点及肌肉做功效率。结果肌肉运动时CP和PP含量明显降低,Pi、Pi/CP和ADP升高,而ATP维持恒定。青少年肌细胞内ATP明显高于成人,而CP和PP含量相似,动态变化趋势相同。成人做功较多,但肌肉的效率与青少年组相同。结论动态磷谱技术可以无创性定量评价骨骼肌不同运动状态能量代谢特点,为肌肉的功能影像学提供客观信息。     

Noninvasive measurement of muscle high-energy phosphates and glycogen concentrations in elite soccer players by 31P- and 13C-MRS

PURPOSE: The purpose of this study was to measure noninvasively the absolute concentrations of muscle adenosine triphosphate [ATP], phosphocreatine [PCr], inorganic phosphate (Pi), and glycogen [Gly] of elite soccer players. METHODS: Magnetic resonance spectroscopy (31P- and 13C-MRS) was used to measure the concentrations of metabolites in the calf muscles of 18 young male players [age = 17.5 +/- 1.0 (SD) yr]. RESULTS: Average muscle [PCr] and [ATP] were 17.8 +/- 3.3 and 6.0 +/- 1.2 mmol x (kg wet weight)(-1), respectively. The ratios of Pi/PCr and PCr/ATP were 0.15 +/- 0.05 and 3.00 +/- 0.26, respectively. The muscle [Gly] was 144 +/- 54 mmol x (kg wet weight)(-1). There was a high correlation (r = 0.93, P < 0.0001) between muscle ATP and PCr concentrations, but there was no correlation between [Gly] and [PCr] or [ATP]. The concentrations of the different metabolites determined in the present study with noninvasive MRS methods were within the ranges of values reported in human muscle from biochemical analysis of muscle biopsies. CONCLUSION: MRS methods can be utilized to assess noninvasively the muscle energetic status of elite soccer players during a soccer season. The high correlation between ATP and PCr might be indicative of fiber type differences in the content of these two metabolites.     

Creatine supplementation--part II: in vivo magnetic resonance spectroscopy

PURPOSE: Our purpose was to study effects of creatine (Cr) supplementation on muscle metabolites noninvasively by means of magnetic resonance spectroscopy (MRS) before and after supplementation with Cr or placebo. METHODS: 1H-MRS was used in a comprehensive, double-blind, cross-over study in 10 volunteers to measure Cr in m. tibialis anterior and m. rectus femoris at rest. PCr/ATP was observed in m. quadriceps femoris by 31P-MRS at rest and after exercise. RESULTS: A significant increase in total Cr was observed with Cr intake in m. tibialis anterior (+9.6 +/- 1.7%, P = 0.001) and in m. rectus femoris (+18.0 +/- 1.8%, P < 0.001). PCr/ATP showed a significant increase (+23.9 +/- 2.3%, P < 0.001) in m. quadriceps femoris at rest with Cr supplementation. Post-Cr supplementation recovery rates from exercise were significantly lower (k = 0.029 s(-1), P < 0.01) compared with postplacebo consumption (k = 0.034 s(-1)) and presupplementation (k = 0.037 s(-1)). However, higher levels of PCr/ATP at rest compensate for this reduction of the recovery rate after Cr supplementation. The increase of PCr/ATP determined by 31P-MRS correlates with the increase of Cr observed by 1H-MRS (r = 0.824, P < 0.001). CONCLUSION: Noninvasive observation of Cr and PCr after Cr supplementation shows an increase in a muscle specific manner. Higher preexercise levels of PCr/ATP at rest compensate for significantly slower recovery rates of PCr/ATP after Cr supplementation.     

Feasibility of rapid-sequence 31P magnetic resonance spectroscopy in cardiac patients

PURPOSE: To determine the clinical feasibility of rapid-sequence phosphorus-31 magnetic resonance spectroscopy (31P-MRS) of the heart with cardiac patients using a 1.5T clinical MR system. MATERIAL AND METHODS: Twenty cardiac patients, i.e. dilated cardiomyopathy (DCM) 13 cases, hypertrophic cardiomyopathy (HCM) 3 cases, hypertensive heart diseases (HHD) 3 cases, and aortic regurgitation (AR) 1 case were examined using rapid cardiac 31P-MRS. Complete three-dimensional localization was performed using a two-dimensional phosphorus chemical-shift imaging sequence in combination with 30-mm axial slice-selective excitation. The rapid-sequence 31P-MRS procedure was phase encoded in arrays of 8 x 8 steps with an average of 4 acquisitions. The total examination time, including proton imaging and shimming, for the rapid cardiac 31P-MRS procedure, ranged from 10 to 15 min, depending on the heart rate. Student's t test was used to compare creatine phosphate (PCr)/adenosine triphosphate (ATP) ratios from the cardiac patients with those of the control subjects (n = 13). RESULTS: The myocardial PCr/ATP ratio obtained by rapid 31P-MRS was significantly lower (P < 0.001) in DCM patients (1.82 +/- 0.33, mean +/- SD), and in patients with global myocardial dysfunction (combined data for 20 patients: 1.89 +/- 0.32) than in normal volunteers (2.96 +/- 0.59). These results are similar to previous studies. CONCLUSION: Rapid-sequence 31P-MRS may be a valid diagnostic tool for patients with cardiac disease.     

Rapid-sequence phosphorus-31 magnetic resonance spectroscopy of the human heart using a 1.5-T clinical system

PURPOSE: To compare a 'standard' slow phosphorus-31 magnetic resonance spectroscopy (31P-MRS) sequence with two faster sequences in phantoms and healthy volunteers using a 1.5-T clinical system. MATERIAL AND METHODS: Complete 3D localization was performed using a 2D phosphorus chemical-shift imaging sequence in combination with 30-mm axial slice-selective excitation. Two 31P-MRS rapid sequences (RS8-4: 8 x 8 phase-encoding, with an average of 4 acquisitions, and RS16-1: 16 x 16 phase-encoding, 1 acquisition) were compared with the standard sequence (StdP: 16 x 16 phase-encoding, with an average of 8 acquisitions) in phantom and healthy volunteers. RESULTS: Acquisition time for the 31P-MRS procedure with StdP, RS8-4, and RS16-1 in the healthy volunteer studies ranged from 30 to 45, 3 to 5, and 3 to 5 minutes, respectively. Metabolite measurements of healthy volunteers obtained from 31P-MRS using RS8-4 correlated with values obtained using StdP (PCr r2=0.63, P<0.001; ATP r=0.41, P<0.01 and PCr/ATP ratio r2=0.25, P<0.05). There was no correlation between StdP and RS16-1 for either ATP or the PCr/ATP ratio (r2=0.03, P=0.60, and r2=0.11, p=0.26, respectively). Reproducibility (intensity of phosphorus signal) with RS16-1 was worse than that of RS8-4 or StdP. CONCLUSION: 31P-MRS using RS8-4 may be a valid diagnostic tool for patients with cardiac diseases.