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Kent JA, Hayes KL. Exercise Physiology From 1980 to 2020: Application of the Natural Sciences. KINESIOLOGY REVIEW (CHAMPAIGN, ILL.) 2021; 10:238-247. [PMID: 35464337 PMCID: PMC9022627 DOI: 10.1123/kr.2021-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The field of exercise physiology has enjoyed tremendous growth in the past 40 years. With its foundations in the natural sciences, it is an interdisciplinary field that is highly relevant to human performance and health. The focus of this review is on highlighting new approaches, knowledge, and opportunities that have emerged in exercise physiology over the last four decades. Key among these is the adoption of advanced technologies by exercise physiologists to address fundamental research questions, and the expansion of research topics to range from molecular to organismal, and population scales in order to clarify the underlying mechanisms and impact of physiological responses to exercise in health and disease. Collectively, these advances have ensured the position of the field as a partner in generating new knowledge across many scientific and health disciplines.
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Affiliation(s)
- Jane A Kent
- Muscle Physiology Laboratory, Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Kate L Hayes
- Muscle Physiology Laboratory, Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts, USA
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2
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Krššák M, Lindeboom L, Schrauwen‐Hinderling V, Szczepaniak LS, Derave W, Lundbom J, Befroy D, Schick F, Machann J, Kreis R, Boesch C. Proton magnetic resonance spectroscopy in skeletal muscle: Experts' consensus recommendations. NMR IN BIOMEDICINE 2021; 34:e4266. [PMID: 32022964 PMCID: PMC8244035 DOI: 10.1002/nbm.4266] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/21/2019] [Accepted: 01/15/2020] [Indexed: 05/02/2023]
Abstract
1 H-MR spectroscopy of skeletal muscle provides insight into metabolism that is not available noninvasively by other methods. The recommendations given in this article are intended to guide those who have basic experience in general MRS to the special application of 1 H-MRS in skeletal muscle. The highly organized structure of skeletal muscle leads to effects that change spectral features far beyond simple peak heights, depending on the type and orientation of the muscle. Specific recommendations are given for the acquisition of three particular metabolites (intramyocellular lipids, carnosine and acetylcarnitine) and for preconditioning of experiments and instructions to study volunteers.
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Affiliation(s)
- Martin Krššák
- Division of Endocrinology and Metabolism, Department of Internal Medicine III & High Field MR Centre, Department of Biomedical Imaging and Image guided TherapyMedical University of ViennaViennaAustria
| | - Lucas Lindeboom
- Department of Radiology and Nuclear Medicine and Department of Nutrition and Movement ScienceMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Vera Schrauwen‐Hinderling
- Department of Radiology and Nuclear Medicine and Department of Nutrition and Movement ScienceMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Lidia S. Szczepaniak
- Biomedical Research Consulting in Magnetic Resonance SpectroscopyAlbuquerqueNew Mexico
| | - Wim Derave
- Department of Movement and Sports SciencesGhent UniversityGhentBelgium
| | - Jesper Lundbom
- Department of Diagnostics and TherapeuticsUniversity of HelsinkiHelsinkiFinland
| | | | - Fritz Schick
- Section on Experimental Radiology, Department of Diagnostic and Interventional RadiologyUniversity Hospital TübingenTübingenGermany
| | - Jürgen Machann
- Section on Experimental Radiology, Department of Diagnostic and Interventional RadiologyUniversity Hospital TübingenTübingenGermany
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of TübingenTübingenGermany
- German Center for Diabetes Research (DZD)TübingenGermany
| | - Roland Kreis
- Departments of Radiology and Biomedical ResearchUniversity and InselspitalBernSwitzerland
| | - Chris Boesch
- Departments of Radiology and Biomedical ResearchUniversity and InselspitalBernSwitzerland
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3
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Gerhalter T, Carlier PG, Marty B. Acute changes in extracellular volume fraction in skeletal muscle monitored by 23Na NMR spectroscopy. Physiol Rep 2018; 5:5/16/e13380. [PMID: 28867674 PMCID: PMC5582265 DOI: 10.14814/phy2.13380] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/20/2017] [Accepted: 07/14/2017] [Indexed: 11/24/2022] Open
Abstract
In this article, we induced acute changes in extracellular volume fraction in skeletal muscle tissue and compared the sensitivity of a standard 1H T2 imaging method with different 23Na‐NMR spectroscopy parameters within acquisition times compatible with clinical investigations. First, we analyzed the effect of a short ischemia on the sodium distribution in the skeletal muscle. Then, the lower leg of 21 healthy volunteers was scanned under different vascular filling conditions (vascular draining, filling, and normal condition) expected to modify exclusively the extracellular volume. The first experiment showed no change in the total sodium content during a 15 min ischemia, but the intracellular weighted 23Na signal slowly decreased. For the second part, significant variations of total sodium content, sodium distribution, and T1 and T2∗ of 23Na signal were observed between different vascular filling conditions. The measured sodium distribution correlates significantly with sodium T1 and with the short and long T2∗ fractions. In contrast, significant changes in the proton T2w signal were observed only in three muscles. Altogether, the mean T2w signal intensity of all muscles as well as their mean T2 did not vary significantly with the extracellular volume changes. In conclusion, at the expense of giving up spatial resolution, the proposed 23Na spectroscopic method proved to be more sensitive than standard 1H T2 approach to monitor acute extracellular compartment changes within muscle tissue.
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Affiliation(s)
- Teresa Gerhalter
- Institute of Myology, NMR Laboratory, Paris, France .,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
| | - Pierre G Carlier
- Institute of Myology, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
| | - Benjamin Marty
- Institute of Myology, NMR Laboratory, Paris, France.,CEA, DRF, IBFJ, MIRCen, NMR Laboratory, Paris, France
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4
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Carlier PG, Marty B, Scheidegger O, Loureiro de Sousa P, Baudin PY, Snezhko E, Vlodavets D. Skeletal Muscle Quantitative Nuclear Magnetic Resonance Imaging and Spectroscopy as an Outcome Measure for Clinical Trials. J Neuromuscul Dis 2018; 3:1-28. [PMID: 27854210 PMCID: PMC5271435 DOI: 10.3233/jnd-160145] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Recent years have seen tremendous progress towards therapy of many previously incurable neuromuscular diseases. This new context has acted as a driving force for the development of novel non-invasive outcome measures. These can be organized in three main categories: functional tools, fluid biomarkers and imagery. In the latest category, nuclear magnetic resonance imaging (NMRI) offers a considerable range of possibilities for the characterization of skeletal muscle composition, function and metabolism. Nowadays, three NMR outcome measures are frequently integrated in clinical research protocols. They are: 1/ the muscle cross sectional area or volume, 2/ the percentage of intramuscular fat and 3/ the muscle water T2, which quantity muscle trophicity, chronic fatty degenerative changes and oedema (or more broadly, “disease activity”), respectively. A fourth biomarker, the contractile tissue volume is easily derived from the first two ones. The fat fraction maps most often acquired with Dixon sequences have proven their capability to detect small changes in muscle composition and have repeatedly shown superior sensitivity over standard functional evaluation. This outcome measure will more than likely be the first of the series to be validated as an endpoint by regulatory agencies. The versatility of contrast generated by NMR has opened many additional possibilities for characterization of the skeletal muscle and will result in the proposal of more NMR biomarkers. Ultra-short TE (UTE) sequences, late gadolinium enhancement and NMR elastography are being investigated as candidates to evaluate skeletal muscle interstitial fibrosis. Many options exist to measure muscle perfusion and oxygenation by NMR. Diffusion NMR as well as texture analysis algorithms could generate complementary information on muscle organization at microscopic and mesoscopic scales, respectively. 31P NMR spectroscopy is the reference technique to assess muscle energetics non-invasively during and after exercise. In dystrophic muscle, 31P NMR spectrum at rest is profoundly perturbed, and several resonances inform on cell membrane integrity. Considerable efforts are being directed towards acceleration of image acquisitions using a variety of approaches, from the extraction of fat content and water T2 maps from one single acquisition to partial matrices acquisition schemes. Spectacular decreases in examination time are expected in the near future. They will reinforce the attractiveness of NMR outcome measures and will further facilitate their integration in clinical research trials.
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Affiliation(s)
- Pierre G Carlier
- Institute of Myology, Pitie-Salpetriere University Hospital, Paris, France.,CEA, DSV, I2BM, MIRCen, NMR Laboratory, Paris, France.,National Academy of Sciences, United Institute for Informatics Problems, Minsk, Belarus
| | - Benjamin Marty
- Institute of Myology, Pitie-Salpetriere University Hospital, Paris, France.,CEA, DSV, I2BM, MIRCen, NMR Laboratory, Paris, France
| | - Olivier Scheidegger
- Institute of Myology, Pitie-Salpetriere University Hospital, Paris, France.,Support Center for Advanced Neuroimaging (SCAN), Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, and University of Bern, Switzerland
| | | | | | - Eduard Snezhko
- National Academy of Sciences, United Institute for Informatics Problems, Minsk, Belarus
| | - Dmitry Vlodavets
- N.I. Prirogov Russian National Medical Research University, Clinical Research Institute of Pediatrics, Moscow, Russian Federation
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5
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Le Roux-Mallouf T, Vibert F, Doutreleau S, Verges S. Effect of acute nitrate and citrulline supplementation on muscle microvascular response to ischemia-reperfusion in healthy humans. Appl Physiol Nutr Metab 2017; 42:901-908. [PMID: 28460182 DOI: 10.1139/apnm-2017-0081] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Nitric oxide (NO) is implicated in vasomotor control mechanisms altering the diameter of the vessels under various physiological and pathological conditions. There are 2 main NO production pathways, 1 NO synthase (NOS) independent (nitrate-nitrite-NO) and the other is NOS dependent (citrulline-arginine-NO). The objective of the study was to evaluate the effect of acute nitrate and citrulline supplementation on post-ischemic vascular response in healthy subjects. Fourteen subjects performed 2-leg vascular occlusion tests, 3 days apart. They were randomly assigned to consume a drink containing 1200 mg (19.4 mmol) of nitrate and 6 g of citrulline (N+C) or a placebo (Pl). Changes in total hemoglobin (Hbtot) and oxyhemoglobin (HbO2) concentrations were recorded by near-infrared spectroscopy on the thigh and calf muscles. No differences between N+C and Pl were observed during the ischemic period. Hbtot increased to a larger extent during the reperfusion period for the thigh (e.g., area under the curve, 821 ± 324 vs. 627 ± 381 mmol·s-1, p = 0.003) and the calf (515 ± 285 vs. 400 ± 275 mmol·s-1, p = 0.029) in the N+C versus Pl conditions. Similar results were found regarding HbO2 for the thigh (e.g., area under the curve, 842 ± 502 vs. 770 ± 491 mmol·s-1, p = 0.077) and the calf (968 ± 536 vs. 865 ± 275 mmol·s-1, p = 0.075). The larger postocclusive Hbtot and HbO2 responses observed after N+C intake suggests a greater post-ischemic vasodilation, which may be due to increased NO availability, via the activation of the 2 main NO production pathways.
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Affiliation(s)
- Thibault Le Roux-Mallouf
- U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France.,U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France
| | - Florence Vibert
- U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France.,U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France
| | - Stéphane Doutreleau
- U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France.,U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France
| | - Samuel Verges
- U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France.,U1042, INSERM, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France; HP2 Laboratory, Univ. Grenoble Alpes, Jean Roget Building, Faculty of Medicine, F-38042 Grenoble, France
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6
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Meyerspeer M, Magill AW, Kuehne A, Gruetter R, Moser E, Schmid AI. Simultaneous and interleaved acquisition of NMR signals from different nuclei with a clinical MRI scanner. Magn Reson Med 2015; 76:1636-1641. [PMID: 26608834 PMCID: PMC4996325 DOI: 10.1002/mrm.26056] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 10/16/2015] [Accepted: 10/25/2015] [Indexed: 11/17/2022]
Abstract
Purpose Modification of a clinical MRI scanner to enable simultaneous or rapid interleaved acquisition of signals from two different nuclei. Methods A device was developed to modify the local oscillator signal fed to the receive channel(s) of an MRI console. This enables external modification of the frequency at which the receiver is sensitive and rapid switching between different frequencies. Use of the device was demonstrated with interleaved and simultaneous 31P and 1H spectroscopic acquisitions, and with interleaved 31P and 1H imaging. Results Signal amplitudes and signal‐to‐noise ratios were found to be unchanged for the modified system, compared with data acquired with the MRI system in the standard configuration. Conclusion Interleaved and simultaneous 1H and 31P signal acquisition was successfully demonstrated with a clinical MRI scanner, with only minor modification of the RF architecture. While demonstrated with 31P, the modification is applicable to any detectable nucleus without further modification, enabling a wide range of simultaneous and interleaved experiments to be performed within a clinical setting. Magn Reson Med 76:1636–1641, 2016. © 2015 The Authors. Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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Affiliation(s)
- Martin Meyerspeer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria. .,MR Centre of Excellence, Medical University of Vienna, Austria. .,Laboratory for Functional and Metabolic Imaging, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
| | - Arthur W Magill
- Laboratory for Functional and Metabolic Imaging, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Department of Radiology, University of Lausanne, Lausanne, Switzerland
| | - Andre Kuehne
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria.,MR Centre of Excellence, Medical University of Vienna, Austria
| | - Rolf Gruetter
- Laboratory for Functional and Metabolic Imaging, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.,Department of Radiology, University of Lausanne, Lausanne, Switzerland.,Department of Radiology, University of Geneva, Geneva, Switzerland
| | - Ewald Moser
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria.,MR Centre of Excellence, Medical University of Vienna, Austria
| | - Albrecht Ingo Schmid
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria.,MR Centre of Excellence, Medical University of Vienna, Austria
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Decorte N, Buehler T, Caldas de Almeida Araujo E, Vignaud A, Carlier PG. Noninvasive estimation of oxygen consumption in human calf muscle through combined NMR measurements of ASL perfusion and T₂ oxymetry. J Vasc Res 2014; 51:360-8. [PMID: 25531648 DOI: 10.1159/000368194] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 09/03/2014] [Indexed: 11/19/2022] Open
Abstract
The objective of this work was to demonstrate the feasibility of measuring muscle O2 consumption (V˙O2) noninvasively with a combination of functional nuclear magnetic resonance (NMR) imaging methods, and to verify that changes in muscle V˙O2 can be detected with a temporal resolution compatible with physiological investigation and patient ease. T2-based oxymetry of arterial and venous blood was combined with the arterial-spin labeling (ASL)-based determination of muscle perfusion. These measurements were performed on 8 healthy volunteers under normoxic and hypoxic conditions in order to assess the sensitivity of measurements over a range of saturation values. Blood samples were drawn simultaneously and used to titrate blood T2 measurements versus hemoglobin O2 saturation (%HbO2) in vitro. The in vitro calibration curve of blood T2 fitted very well with the %HbO2 (r(2): 0.95). The in vivo venous T2 measurements agreed well with the in vitro measurements (intraclass correlation coefficient 0.82, 95% confidence interval 0.61-0.91). Oxygen extraction at rest decreased in the calf muscles subjected to hypoxia (p = 0.031). The combination of unaltered muscle perfusion and pinched arteriovenous O2 difference (p = 0.038) pointed towards a reduced calf muscle V˙O2 during transient hypoxia (p = 0.018). The results of this pilot study confirmed that muscle O2 extraction and V˙O2 can be estimated noninvasively using a combination of functional NMR techniques. Further studies are needed to confirm the usefulness in a larger sample of volunteers and patients.
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8
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Englund EK, Langham MC, Li C, Rodgers ZB, Floyd TF, Mohler ER, Wehrli FW. Combined measurement of perfusion, venous oxygen saturation, and skeletal muscle T2* during reactive hyperemia in the leg. J Cardiovasc Magn Reson 2013; 15:70. [PMID: 23958293 PMCID: PMC3765712 DOI: 10.1186/1532-429x-15-70] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 07/30/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The function of the peripheral microvascular may be interrogated by measuring perfusion, tissue oxygen concentration, or venous oxygen saturation (SvO2) recovery dynamics following induced ischemia. The purpose of this work is to develop and evaluate a magnetic resonance (MR) technique for simultaneous measurement of perfusion, SvO2, and skeletal muscle T2*. METHODS Perfusion, Intravascular Venous Oxygen saturation, and T2* (PIVOT) is comprised of interleaved pulsed arterial spin labeling (PASL) and multi-echo gradient-recalled echo (GRE) sequences. During the PASL post-labeling delay, images are acquired with a multi-echo GRE to quantify SvO2 and T2* at a downstream slice location. Thus time-courses of perfusion, SvO2, and T2* are quantified simultaneously within a single scan. The new sequence was compared to separately measured PASL or multi-echo GRE data during reactive hyperemia in five young healthy subjects. To explore the impairment present in peripheral artery disease patients, five patients were evaluated with PIVOT. RESULTS Comparison of PIVOT-derived data to the standard techniques shows that there was no significant bias in any of the time-course-derived metrics. Preliminary data show that PAD patients exhibited alterations in perfusion, SvO2, and T2* time-courses compared to young healthy subjects. CONCLUSION Simultaneous quantification of perfusion, SvO2, and T2* is possible with PIVOT. Kinetics of perfusion, SvO2, and T2* during reactive hyperemia may help to provide insight into the function of the peripheral microvasculature in patients with PAD.
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Affiliation(s)
- Erin K Englund
- Department of Radiology, Laboratory of Structural NMR Imaging, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Michael C Langham
- Department of Radiology, Laboratory of Structural NMR Imaging, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Cheng Li
- Department of Radiology, Laboratory of Structural NMR Imaging, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Zachary B Rodgers
- Department of Radiology, Laboratory of Structural NMR Imaging, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Thomas F Floyd
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY 11794, USA
| | - Emile R Mohler
- Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Felix W Wehrli
- Department of Radiology, Laboratory of Structural NMR Imaging, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA
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Skeletal muscle perfusion and oxygenation assessed by dynamic NMR imaging and spectroscopy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2011; 701:341-6. [PMID: 21445807 DOI: 10.1007/978-1-4419-7756-4_46] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Muscle perfusion, and capillary and intramyocytic oxygenation can be probed non-invasively in vivo by functional NMR techniques, arterial spin labelling combined with imaging, BOLD imaging and deoxymyoglobin (1)H spectroscopy, respectively. After adequate adaptation of equipment, these measurements can be performed in parallel, together with (31)P spectroscopy and provide a comprehensive analysis of various facets of oxygen metabolism in dynamic protocols, in humans as well as in animal models.
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Moser E, Meyerspeer M, Fischmeister FPS, Grabner G, Bauer H, Trattnig S. Windows on the human body--in vivo high-field magnetic resonance research and applications in medicine and psychology. SENSORS (BASEL, SWITZERLAND) 2010; 10:5724-57. [PMID: 22219684 PMCID: PMC3247729 DOI: 10.3390/s100605724] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Revised: 04/02/2010] [Accepted: 05/17/2010] [Indexed: 12/30/2022]
Abstract
Analogous to the evolution of biological sensor-systems, the progress in "medical sensor-systems", i.e., diagnostic procedures, is paradigmatically described. Outstanding highlights of this progress are magnetic resonance imaging (MRI) and spectroscopy (MRS), which enable non-invasive, in vivo acquisition of morphological, functional, and metabolic information from the human body with unsurpassed quality. Recent achievements in high and ultra-high field MR (at 3 and 7 Tesla) are described, and representative research applications in Medicine and Psychology in Austria are discussed. Finally, an overview of current and prospective research in multi-modal imaging, potential clinical applications, as well as current limitations and challenges is given.
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Affiliation(s)
- Ewald Moser
- MR Center of Excellence, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria; E-Mails: (M.M.); (F.Ph.S.F.); (G.G.); (S.T.)
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
- Department of Diagnostic Radiology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Martin Meyerspeer
- MR Center of Excellence, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria; E-Mails: (M.M.); (F.Ph.S.F.); (G.G.); (S.T.)
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Florian Ph. S. Fischmeister
- MR Center of Excellence, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria; E-Mails: (M.M.); (F.Ph.S.F.); (G.G.); (S.T.)
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
- Brain Research Lab, Department of Clinical, Biological and Differential Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria; E-Mail:
| | - Günther Grabner
- MR Center of Excellence, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria; E-Mails: (M.M.); (F.Ph.S.F.); (G.G.); (S.T.)
- Department of Diagnostic Radiology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Herbert Bauer
- Brain Research Lab, Department of Clinical, Biological and Differential Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria; E-Mail:
| | - Siegfried Trattnig
- MR Center of Excellence, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria; E-Mails: (M.M.); (F.Ph.S.F.); (G.G.); (S.T.)
- Department of Diagnostic Radiology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
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11
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Wray DW, Nishiyama SK, Monnet A, Wary C, Duteil S, Carlier PG, Richardson RS. Multiparametric NMR-based assessment of skeletal muscle perfusion and metabolism during exercise in elderly persons: preliminary findings. J Gerontol A Biol Sci Med Sci 2009; 64:968-74. [PMID: 19377015 DOI: 10.1093/gerona/glp044] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Aging is associated with a decline in exercise capacity that may be attributable to maladaptations in both skeletal muscle perfusion and metabolism; yet very little is known regarding the real-time, within-muscle interplay between these parameters during physical activity. Therefore, we utilized an unique nuclear magnetic resonance sequence to concomitantly examine changes in lower leg skeletal muscle perfusion and metabolism. METHODS In young (26+/-5 years, n=6) and older (70+/-5 years, n=6) healthy volunteers, arterial spin labeling measurements of muscle perfusion were combined with 31 Phosphorous (31P) nuclear magnetic resonance spectroscopy to monitor high-energy phosphate metabolites during and after 5 minutes of moderate-intensity (approximately 5W) plantar flexion exercise. RESULTS Compared with young, end-exercise perfusion was diminished in older participants (43+/-10 mL/100 g/minute, old; 60+/-7 mL/100 g.minute, young), accompanied by greater phosphocreatine (PCr) depletion (-28%+/-12%, old; -19%+/-7%, young) and elevated inorganic phosphate/PCr (0.41+/-0.2, old; 0.24+/-0.09, young); yet the time constant for PCr recovery (tau, an index of muscle oxidative capacity) was similar between groups (51+/-17 seconds, old; 48+/-7 seconds, young). CONCLUSIONS Together, these preliminary data provide evidence of an age-related decline in tissue perfusion and increased "metabolic stress" during exercise but demonstrate that overall oxidative capacity in the elderly does not appear negatively affected by this relatively hypoperfused state.
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Affiliation(s)
- D Walter Wray
- Department of Internal Medicine, University of California San Diego, La Jolla, CA, USA.
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12
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Tevald MA, Lanza IR, Befroy DE, Kent-Braun JA. Intramyocellular oxygenation during ischemic muscle contractions in vivo. Eur J Appl Physiol 2009; 106:333-43. [PMID: 19277696 DOI: 10.1007/s00421-009-1021-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2009] [Indexed: 11/24/2022]
Abstract
There is some evidence that the fall in intramyocellular oxygen content during ischemic contractions is less than during ischemia alone. We used proton magnetic resonance spectroscopy to determine whether peak deoxy-myoglobin (dMb) obtained during ischemic ankle dorsiflexion contractions attained the maximal dMb level observed during a separate trial of ischemia alone (resting max). In six healthy young men, the rate of myoglobin desaturation was rapid at the onset of ischemic contractions and then slowed as contractions continued, attaining only 75 +/- 3.3% (mean +/- SE) of resting max dMb by the end of contractions (p = 0.03). Myoglobin continued to desaturate while ischemia was maintained following contractions, reaching 98 +/- 1.8% of resting max within 10 min (p = 0.03 vs. end of contractions). Notably, contractions performed after 10 min of ischemia did not affect dMb (dMb = 100 +/- 1.5% of resting max, p > 0.99), suggesting that full desaturation had already been achieved. The blunting of desaturation during ischemic contractions is likely a result of slowed mitochondrial oxygen consumption due to limited oxygen availability.
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Affiliation(s)
- Michael A Tevald
- Kinesiology Department, University of Massachusetts, Amherst, MA, 01003, USA
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13
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Quantitative, dynamic and noninvasive determination of skeletal muscle perfusion in mouse leg by NMR arterial spin-labeled imaging. Magn Reson Imaging 2008; 26:1259-65. [DOI: 10.1016/j.mri.2008.02.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Revised: 02/01/2008] [Accepted: 02/11/2008] [Indexed: 11/23/2022]
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14
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Abstract
Magnetic resonance spectroscopy (MRS) of skeletal muscle has been successfully applied by physiologists over several decades, particularly for studies of high-energy phosphates (by (31)P-MRS) and glycogen (by (13)C-MRS). Unfortunately, the observation of these heteronuclei requires equipment that is typically not available on clinical MR scanners, such as broadband capability and a second channel for decoupling and nuclear Overhauser enhancement (NOE). On the other hand, (1)H-MR spectra of skeletal muscle can be acquired on many routine MR systems and also provide a wealth of physiological information. In particular, studies of intramyocellular lipids (IMCL) attract physiologists and endocrinologists because IMCL levels are related to insulin resistance and thus can lead to a better understanding of major health problems in industrial countries. The combination of (1)H-, (13)C-, and (31)P-MRS gives access to the major long- and short-term energy sources of skeletal muscle. This review summarizes the technical aspects and unique MR-methodological features of the different nuclei. It reviews clinical studies that employed MRS of one or more nuclei, or combinations of MRS with other MR modalities. It also illustrates that MR spectra contain additional physiological information that is not yet used in routine clinical applications.
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Affiliation(s)
- Chris Boesch
- Department of Clinical Research, MR-Spectroscopy and Methodology, University of Bern, Bern, Switzerland.
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15
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Carlier PG, Bertoldi D, Baligand C, Wary C, Fromes Y. Muscle blood flow and oxygenation measured by NMR imaging and spectroscopy. NMR IN BIOMEDICINE 2006; 19:954-67. [PMID: 17075963 DOI: 10.1002/nbm.1081] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Tissue perfusion and oxygenation in many organs can be evaluated by various NMR techniques. This review focuses on the specificities, limitations and adaptations of the NMR tools available to investigate perfusion and oxygenation in the skeletal muscle of humans and animal models. A description of how they may be used simultaneously is provided as well. 1H NMR spectroscopy of myoglobin (Mb) monitors intramyocytic oxygenation. It measures the level of deoxy-Mb, from which Mb concentration, Mb desaturation/resaturation rates, muscle oxygenation changes and intracellular partial oxygen pressure (pO2) can be calculated. Positive and negative blood oxygen level-dependent (BOLD) contrasts exist in skeletal muscle. BOLD contrasts primarily reflect changes in capillary-venous oxygenation, but are also directly or indirectly dependent on muscle blood volume, perfusion, vascular network architecture and angulation, relative to the main magnetic field. Arterial spin labelling (ASL) techniques, having high spatial and temporal resolution, are the methods of choice to quantify and map skeletal muscle perfusion non-invasively. Limitations of ASL are poor contrast-to-noise ratio and sensitivity to movement; however, with the introduction of specific adaptations, it has been proven possible to measure skeletal muscle perfusion at both rest and during exercise. The possibility of combining these NMR measurements with others into a single dynamic protocol is most interesting. The 'multiparametric functional (mpf) NMR' concept can be extended to include the evaluation of muscle energy metabolism simultaneously with 31P NMR or with lactate double quantum filtered 1H NMR spectroscopy, an approach which would make NMR an exceptional tool for non-invasive investigations of integrative physiology and biochemistry in skeletal muscle in vivo.
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Affiliation(s)
- P G Carlier
- NMR Laboratory, AFM and CEA, Pitié-Salpêtrière University Hospital, 75013 Paris, France
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16
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Frouin F, Duteil S, Lesage D, Carlier PG, Herment A, Leroy-Willig A. An automated image-processing strategy to analyze dynamic arterial spin labeling perfusion studies. Application to human skeletal muscle under stress. Magn Reson Imaging 2006; 24:941-51. [PMID: 16916711 DOI: 10.1016/j.mri.2005.09.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2005] [Revised: 09/23/2005] [Accepted: 09/23/2005] [Indexed: 11/18/2022]
Abstract
Arterial spin labeling (ASL) perfusion measurements allow the follow-up of muscle perfusion with high temporal resolution during a stress test. Automated image processing is proposed to estimate perfusion maps from ASL images. It is based on two successive analyses: at first, automated rejection of the image pairs between which a large displacement is detected is performed, followed by factor analysis of the dynamic data and cluster analysis to classify pixels with large signal variation characteristic of vessels. Then, after masking these "vascular" pixels, factor analysis and cluster analysis are further applied to separate the different muscles between low or high perfusion increase, yielding a functional map of the leg. Data from 10 subjects (five normal volunteers and five elite sportsmen) had been analyzed. Resulting time perfusion curves from a region of interest (ROI) in active muscles show a good accordance whether extracted with automated processing or with manual processing. This method of functional segmentation allows automated suppression of vessels and fast visualization of muscles with high, medium or low perfusion, without any a priori knowledge.
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Bendahan D, Mattei JP, Guis S, Kozak-Ribbens G, Cozzone PJ. [Non-invasive investigation of muscle function using 31P magnetic resonance spectroscopy and 1H MR imaging]. Rev Neurol (Paris) 2006; 162:467-84. [PMID: 16585908 DOI: 10.1016/s0035-3787(06)75038-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
31P MRS and 1H MRI of skeletal muscle have become major new tools allowing a complete non invasive investigation of muscle function both in the clinical setting and in basic research. The comparative analysis of normal and diseased muscle remains a major requirement to further define metabolic events surrounding muscle contraction and the metabolic anomalies underlying pathologies. Also, standardized rest-exercise-recovery protocols for the exploration of muscle metabolism by P-31 MRS in healthy volunteers as well as in patients with intolerance to exercise have been developed. The CRMBM protocol is based on a short-term intense exercise, which is very informative and well accepted by volunteers and patients. Invariant metabolic parameters have been defined to characterize the normal metabolic response to the protocol. Deviations from normality can be directly interpreted in terms of specific pathologies in some favorable cases. This protocol has been applied to more than 4,000 patients and healthy volunteers over a period of 15 years. On the other hand, MRI investigations provide anatomical and functional information from resting and exercising muscle. From a diagnostic point of view, dedicated pulse sequences can be used in order to detect and quantify muscle inflammation, fatty replacement, muscle hyper and hypotrophy. In most cases, MR techniques provide valuable information which has to be processed in conjunction with traditional invasive biochemical, electrophysiological and histoenzymological tests. P-31 MRS has proved particularly useful in the therapeutic follow-up of palliative therapies (coenzyme Q treatment of mitochondriopathies) and in family investigations. It is now an accepted diagnostic tool in the array of tests which are used to characterize muscle disorders in clinical routine. As a research tool, it will keep bringing new information on the physiopathology of muscle diseases in animal models and in humans and should play a role in the metabolic characterization of gene and cell therapy.
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Affiliation(s)
- D Bendahan
- Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR CNRS No 6612, Faculté de Médecine de Marseille.
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Duteil S, Wary C, Raynaud JS, Lebon V, Lesage D, Leroy-Willig A, Carlier PG. Influence of vascular filling and perfusion on BOLD contrast during reactive hyperemia in human skeletal muscle. Magn Reson Med 2006; 55:450-4. [PMID: 16342333 DOI: 10.1002/mrm.20760] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Mechanisms generating BOLD contrast are complex and depend on parameters that are prone to large variations, in particular in skeletal muscle. Here, we simultaneously measured perfusion by ASL, and BOLD response in the calf muscle of 6 healthy volunteers during post-ischemic reactive hyperemia. We tested whether the relation between the two was altered for varying degrees of leg vascular replenishment induced by prior positioning of the leg at different heights relative to the heart. We found that the BOLD response depended on perfusion, but also on the degree of repletion of leg blood vessels. We conclude that simultaneous determination of perfusion by ASL is important to identify the mechanisms underlying BOLD contrast in the skeletal muscle.
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Affiliation(s)
- S Duteil
- NMR Laboratory, AFM and CEA, IFR 14, Institut de Myologie, Pitié-Salpêtrière University Hospital, Paris, France
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Bertoldi D, Parzy E, Fromes Y, Wary C, Leroy-Willig A, Carlier PG. New insight into abnormal muscle vasodilatory responses in aged hypertensive rats by in vivo nuclear magnetic resonance imaging of perfusion. J Vasc Res 2006; 43:149-56. [PMID: 16407660 DOI: 10.1159/000090944] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2004] [Accepted: 10/16/2005] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE Increased peripheral arterial resistances and decreased maximum vasodilation are characteristic features of chronic hypertension. However, little data are available in the literature regarding the possible alterations in the temporal patterns of vasodilatory responses elicited by various stimuli. DESIGN This question was addressed by measuring skeletal muscle perfusion using nuclear magnetic resonance imaging combined with arterial spin labeling. METHODS Ninety-week-old male spontaneously hypertensive (SHR; n = 7) and normotensive Wistar Kyoto (WKY; n = 8) rats were studied, and calf muscle perfusion was measured at rest and during reactive hyperemia following total ischemia of 5 and 30 min duration. RESULTS Reactive hyperemia profiles differed according to duration of ischemia. In WKY rats, 5 min of ischemia induced a short peak of hyperemia lasting no more than 63 s, while 30 min of ischemia were followed by a prolonged hyperemic response of 261 s. In SHRs, after 5 min of ischemia, peak muscle arterial conductance was decreased to 0.5 +/- 0.3 versus 0.9 +/- 0.3 ml.min(-1).100 g(-1).mm Hg(-1) in the WKY rats (p < 0.05), as expected. After 30 min of ischemia, there was, in addition, a shortening of the hyperemic response duration. Time to post-ischemic half normalization of arterial conductance was 38 +/- 24 s in the SHRs versus 149 +/- 58 s in the WKY rats (p < 0.001). CONCLUSION In vivo perfusion measurement not only confirmed the existence of a reduced maximum peripheral vasodilation in chronically hypertensive rats, it revealed a blunted hyperemic response after prolonged ischemia in the SHRs, which might be an important contributing factor to the increased sensitivity to ischemia in hypertension.
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Affiliation(s)
- Didier Bertoldi
- NMR Laboratory, AFM-CEA, Institute of Myology, IFR 14, Pitié-Salpêtrière University Hospital, Paris, France
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20
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Abstract
Arterial spin labeling (ASL) in combination with NMR imaging is an in vivo technique that quantifies tissue perfusion in absolute values (ml blood x min(-1) x g tissue(-1)) with high temporal (1-10 s) and spatial (0.1-3 mm) resolution. It uses the arterial water spins as endogenous freely diffusible markers of perfusion and, hence, is a totally noninvasive method. The technique has been successfully applied to quantify baseline perfusion in many organs, including the heart, in humans and animals, and results were validated by comparison with gold standards, PET and microspheres, respectively. Because of the high sampling rate of perfusion with ASL and the possibility that measurements could be obtained without harm over indefinite periods of time, the technique has the potential for use in functional investigations of microcirculation regulation and resistance artery control in vivo. We describe examples of the use of ASL to this end. With use of specific technological developments, ASL determination of perfusion can be coupled with simultaneous acquisitions of (1)H and (31)P NMR spectroscopy data. These protocols offer new possibilities whereby the microcirculatory control of cell oxygenation and high-energy phosphate metabolism can be explored.
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Baumgartner I, Thoeny HC, Kummer O, Roefke C, Skjelsvik C, Boesch C, Kreis R. Leg ischemia: assessment with MR angiography and spectroscopy. Radiology 2005; 234:833-41. [PMID: 15681685 DOI: 10.1148/radiol.2343031440] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively determine reproducibility of magnetic resonance (MR) angiography and MR spectroscopy of deoxymyoglobin in assessment of collateral vessels and tissue perfusion in patients with critical limb ischemia (CLI) and to follow changes in patients undergoing intramuscular vascular endothelial growth factor (pVEGF)-C gene therapy, percutaneous transluminal angioplasty, supervised exercise training, or no therapy. MATERIALS AND METHODS Study and gene therapy protocols were approved, and all patients gave written informed consent. To determine repeatability and reproducibility, seven patients underwent MR angiography and five underwent MR spectroscopy. The techniques were used to judge disease progress in 12 other patients with or without therapy: MR angiography to help determine change in visualization of collateral vessels and MR spectroscopy to help assess change in perfusion at proximal and distal calf levels. MR angiographic results were subjectively analyzed by three blinded readers. Intraobserver variability was expressed as 95% confidence interval (CI) (n=7); interobserver variability, as kappa statistic (n=15). Reexamination variability of MR spectroscopy was given as 95% CI for subsequent recovery times, and correlation with disease extent was calculated with Kendall taub rank correlation. Fisher-Yates test was used to correlate changes with pressure measurements and clinical course. RESULTS Intraobserver and interobserver concordance was sensitive for detection of collateral vessels. Intraobserver agreement was 85.7% (95% CI: 42.1%, 99.6%). Interobserver agreement was high for small collateral vessels (kappa=0.74, P <.001) and fair for large collateral vessels (kappa=0.36, P=.002). MR spectroscopy was reproducible (95% CI: +/-26 seconds for proximal, +/-21 seconds for distal) and showed a correlation with disease extent (proximal calf, taub=0.84, P <.001; distal calf, taub=0.68, P=.04). Small collateral vessels increased over time (P=.04) but did not correlate with pressure measurements and clinical course. Recovery time correlated with clinical course (proximal calf, P=.03; distal calf, P=.005). CONCLUSION MR angiography and MR spectroscopy of deoxymyoglobin can help document changes in visualization of collateral vessels and tissue perfusion in patients with CLI.
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Affiliation(s)
- Iris Baumgartner
- Swiss Cardiovascular Center, Division of Angiology and Departments of Diagnostic, Interventional, and Pediatric Radiology, University Hospital Bern, Freiburgstrasse 10, 3010 Bern, Switzerland
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Carlier PG, Brillault-Salvat C, Giacomini E, Wary C, Bloch G. How to investigate oxygen supply, uptake, and utilization simultaneously by interleaved NMR imaging and spectroscopy of the skeletal muscle. Magn Reson Med 2005; 54:1010-3. [DOI: 10.1002/mrm.20649] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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23
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Duteil S, Bourrilhon C, Raynaud JS, Wary C, Richardson RS, Leroy-Willig A, Jouanin JC, Guezennec CY, Carlier PG. Metabolic and vascular support for the role of myoglobin in humans: a multiparametric NMR study. Am J Physiol Regul Integr Comp Physiol 2004; 287:R1441-9. [PMID: 15528402 DOI: 10.1152/ajpregu.00242.2004] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In human muscle the role of myoglobin (Mb) and its relationship to factors such as muscle perfusion and metabolic capacity are not well understood. We utilized nuclear magnetic resonance (NMR) to simultaneously study the Mb concentration ([Mb]), perfusion, and metabolic characteristics in calf muscles of athletes trained long term for either sprint or endurance running after plantar flexion exercise and cuff ischemia. The acquisitions for 1H assessment of Mb desaturation and concentration, arterial spin labeling measurement of muscle perfusion, and 31P spectroscopy to monitor high-energy phosphate metabolites were interleaved in a 4-T magnet. The endurance-trained runners had a significantly elevated [Mb] (0.28 ± 0.06 vs. 0.20 ± 0.03 mmol/kg). The time constant of creatine rephosphorylation (τPCr), an indicator of oxidative capacity, was both shorter in the endurance-trained group (34 ± 6 vs. 64 ± 20 s) and negatively correlated with [Mb] across all subjects ( r = 0.58). The time to reach maximal perfusion after cuff release was also both shorter in the endurance-trained group (306 ± 74 vs. 560 ± 240 s) and negatively correlated with [Mb] ( r = 0.56). Finally, Mb reoxygenation rate tended to be higher in the endurance-trained group and was positively correlated with τPCr ( r = 0.75). In summary, these NMR data reveal that [Mb] is increased in human muscle with a high oxidative capacity and a highly responsive vasculature, and the rate at which Mb resaturates is well correlated with the rephosphorylation rate of Cr, each of which support a teleological role for Mb in O2 transport within highly oxidative human skeletal muscle.
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Affiliation(s)
- S Duteil
- NMR Laboratory AFM-CEA, IFR 14, Institute of Myology, Pitié-Salpêtrière University Hospital, Paris Cedex, France
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Leroy-Willig A, Fromes Y, Paturneau-Jouas M, Carlier P. Assessing gene and cell therapies applied in striated skeletal and cardiac muscle: is there a role for nuclear magnetic resonance? Neuromuscul Disord 2003; 13:397-407. [PMID: 12798795 DOI: 10.1016/s0960-8966(03)00035-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Gene and cell therapies convey high hopes for treatment of skeletal and heart muscle diseases. In the experimental protocols under development as well as in the first clinical trials, longitudinal control by an atraumatic procedure is needed. Nuclear magnetic resonance (NMR), via its two modalities, imaging or spectroscopy, should play a major role both for in vivo animal and human studies, because of the great number of parameters that can be measured, sequentially or simultaneously, and because of its aptitude to monitor several steps of protocols, in particular to detect physiological modifications induced by therapies. We review here the many possible applications of nuclear magnetic resonance in gene/cell therapies where muscle is the target organ, with emphasis on the application of nuclear magnetic resonance to functional studies.
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Affiliation(s)
- A Leroy-Willig
- NMR Laboratory (AFM-CEA), Institute of Myology, Pitié-Salpêtrière University Hospital, 47 Boulevard de l'Hôpital, 75651 Paris, France.
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25
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Kreis R, Bruegger K, Skjelsvik C, Zwicky S, Ith M, Jung B, Baumgartner I, Boesch C. Quantitative (1)H magnetic resonance spectroscopy of myoglobin de- and reoxygenation in skeletal muscle: reproducibility and effects of location and disease. Magn Reson Med 2001; 46:240-8. [PMID: 11477626 DOI: 10.1002/mrm.1184] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
1H-magnetic resonance spectroscopy ((1)H-MRS) of deoxymyoglobin (DMb) provides a means to noninvasively monitor the oxygenation state of human skeletal muscle in work and disease. As shown in this work, it also offers the opportunity to measure the absolute tissue content of DMb, the basic oxygen consumption of resting muscle, and the reperfusion characteristics after release of a pressure cuff. The methodology to determine these tissue properties simultaneously at two positions along the calf is presented. The obtained values are in agreement with invasive determinations. The reproducibility of the (1)H-MRS measurements is established for healthy controls and patients with peripheral arterial disease (PAD). A location dependence in axial direction, as well as differences between controls and patients are demonstrated for all parameters. The reoxygenation time in particular is expected to provide a means to quantitatively monitor therapies aimed at improving muscular perfusion in these patients.
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Affiliation(s)
- R Kreis
- Department for Clinical Research (MR Spectroscopy and Methodology), University and Inselspital Bern, Bern, Switzerland.
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26
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Raynaud JS, Duteil S, Vaughan JT, Hennel F, Wary C, Leroy-Willig A, Carlier PG. Determination of skeletal muscle perfusion using arterial spin labeling NMRI: validation by comparison with venous occlusion plethysmography. Magn Reson Med 2001; 46:305-11. [PMID: 11477634 DOI: 10.1002/mrm.1192] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
T(1)-based determination of perfusion was performed with the high temporal and spatial resolution that monitoring of exercise physiology requires. As no data were available on the validation of this approach in human muscles, T(1)-based NMRI of perfusion was compared to standard strain-gauge venous occlusion plethysmography performed simultaneously within a 4 T magnet. Two different situations were investigated in 21 healthy young volunteers: 1) a 5-min ischemia of the leg, or 2) a 2-3 min ischemic exercise consisting of a plantar flexion on an amagnetic ergometer. Leg perfusion was monitored over 5-15 min of the recovery phase, after the air-cuff arterial occlusion had been released. The interesting features of the sequence were the use of a saturation-recovery module for the introduction of a T(1) modulation and of single-shot spin echo for imaging. Spatial resolution was 1.7 x 2.0 mm and temporal resolution was 2 s. For data analysis, ROIs were traced on different muscles and perfusion was calculated from the differences in muscle signal intensity in successive images. To allow comparison with the global measurement of perfusion by plethysmography, the T(1)-based NMR measurements in exercising muscles were rescaled to the leg cross-section. The perfusion measurements obtained by plethysmography and NMRI were in close agreement with a correlation coefficient between 0.87 and 0.92. This indicates that pulsed arterial techniques provide determination of muscle perfusion not only with superior spatial and temporal resolution but also with exactitude.
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Affiliation(s)
- J S Raynaud
- NMR Unit (AFM, CEA and INSERM), Institute of Myology, Pitié-Salpêtrièere University Hospital, Paris, France
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27
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Vanderthommen M, Depresseux JC, Dauchat L, Degueldre C, Croisier JL, Crielaard JM. Spatial distribution of blood flow in electrically stimulated human muscle: a positron emission tomography study. Muscle Nerve 2000; 23:482-9. [PMID: 10716757 DOI: 10.1002/(sici)1097-4598(200004)23:4<482::aid-mus5>3.0.co;2-i] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Neuromuscular electrical stimulation (NMES) was studied with positron emission tomography (PET) and H(2)(15)O in the quadriceps muscle of 11 men. The subjects were submitted to simultaneous bilateral isometric contraction (5 s)-rest (5 s) cycles for 12 min, with a workload corresponding to 5% of quadriceps maximal isometric voluntary torque (QMIVT) for one thigh (5%T) and 10% of QMIVT for the other (10%T). Scans were centered at the electrodes and tissue blood flow (TBF) was evaluated in square regions of interest (ROIs) (3.5 cm(2)) in the transverse section (TS) of both thighs. The mean TBF reached 8.9 mL min(-1) 100 g(-1) in the TS of the 5%T and 11.5 mL min(-1) 100 g(-1) in the TS of the 10%T (P > 0.05). A negative linear relationship was found for both thighs between the ROI-electrode distance and the TBF (P </= 0.009). The mean percentage of activated ROIs (TBF > 5 mL min(-1) 100 g(-1)) was lower in the 5%T than in the 10%T (50.6% vs. 62.2%; P = 0.017). With NMES, the pattern of spatial recruitment appears linked to electrode proximity and is spatially extended. These results confirm the utility of combining NMES with voluntary exercise in the treatment of atrophied muscle.
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Affiliation(s)
- M Vanderthommen
- Department of Physical Medicine, University of Liège, Liège,
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28
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Abstract
Magnetic resonance imaging (MRI) is a well known diagnostic tool in radiology that produces unsurpassed images of the human body, in particular of soft tissue. However, the medical community is often not aware that MRI is an important yet limited segment of magnetic resonance (MR) or nuclear magnetic resonance (NMR) as this method is called in basic science. The tremendous morphological information of MR images sometimes conceal the fact that MR signals in general contain much more information, especially on processes on the molecular level. NMR is successfully used in physics, chemistry, and biology to explore and characterize chemical reactions, molecular conformations, biochemical pathways, solid state material, and many other applications that elucidate invisible characteristics of matter and tissue. In medical applications, knowledge of the molecular background of MRI and in particular MR spectroscopy (MRS) is an inevitable basis to understand molecular phenomenon leading to macroscopic effects visible in diagnostic images or spectra. This review shall provide the necessary background to comprehend molecular aspects of magnetic resonance applications in medicine. An introduction into the physical basics aims at an understanding of some of the molecular mechanisms without extended mathematical treatment. The MR typical terminology is explained such that reading of original MR publications could be facilitated for non-MR experts. Applications in MRI and MRS are intended to illustrate the consequences of molecular effects on images and spectra.
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Affiliation(s)
- C Boesch
- Department of Clinical Research, University of Bern, Switzerland
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29
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Lebon V, Brillault-Salvat C, Bloch G, Leroy-Willig A, Carlier PG. Evidence of muscle BOLD effect revealed by simultaneous interleaved gradient-echo NMRI and myoglobin NMRS during leg ischemia. Magn Reson Med 1998; 40:551-8. [PMID: 9771572 DOI: 10.1002/mrm.1910400408] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The purpose of this work was to investigate the temporal relationship between intensity changes in T2*-weighted NMR images and tissue oxygen content, measured by myoglobin proton NMR spectroscopy, in the skeletal muscle. During an ischemic stress test, the calf muscles of five healthy volunteers were studied at 3 Tesla. An interleaved NMRI-NMRS sequence was used, which made it possible to record T2*-weighted images and myoglobin spectra simultaneously. During ischemia, rapid changes in muscle signal intensity were observed on T2*-weighted images, which immediately preceded myoglobin desaturation. Bearing in mind the respective P50 of hemoglobin and myoglobin, this observation clearly favored the hypothesis that hemoglobin desaturation was responsible for the changes in T2*. This interpretation was further supported by the temporal coincidence between the experimental NMR data and a model of hemoglobin desaturation solely derived from physiological considerations.
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Affiliation(s)
- V Lebon
- CEA, Service Hospitalier Frédéric Joliot, Orsay, France
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30
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Lebon V, Carlier PG, Brillault-Salvat C, Leroy-Willig A. Simultaneous measurement of perfusion and oxygenation changes using a multiple gradient-echo sequence: application to human muscle study. Magn Reson Imaging 1998; 16:721-9. [PMID: 9811138 DOI: 10.1016/s0730-725x(98)00088-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We have developed a magnetic resonance imaging (MRI) technique based on a multiple gradient-echo sequence designed to probe perfusion and oxygenation simultaneously within skeletal muscle. Processing of the images acquired at successive echo times (TEs) generates two functional maps: one of the signal intensity (SI) extrapolated to zero echo time, which is sensitive to perfusion; and a second one of R2*, which reflects oxygenation. An advantage of the processing procedure lies in the selection of tissue of interest through the profile of T2* decay, leading to automatic rejection of pixels containing small vessels. This allows a more specific assessment of tissue perfusion and oxygenation. This technique was demonstrated successfully during post-ischemic reactive hyperemia in human calf. A perfusion peak of 123 mL x 100 g(-)1 x min(-1) was measured immediately after ischemia, whereas R2* value showed an 11.5% decrease at the same time, essentially reflecting blood oxygenation changes. Differences in the time courses of reperfusion and re-oxygenation were observed, oxygenation presenting a slower recovery. The mechanisms responsible for such a differential dynamic response are discussed.
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Affiliation(s)
- V Lebon
- Service Hospitalier Frédéric Joliot, CEA, Orsay, France
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