Book contents
- Frontmatter
- Contents
- Preface
- Acknowledgments
- Abbreviations
- 1 Introduction to MR spectroscopy in vivo
- 2 Pulse sequences and protocol design
- 3 Spectral analysis methods, quantitation, and common artifacts
- 4 Normal regional variations: brain development and aging
- 5 MRS in brain tumors
- 6 MRS in stroke and hypoxic–ischemic encephalopathy
- 7 MRS in infectious, inflammatory, and demyelinating lesions
- 8 MRS in epilepsy
- 9 MRS in neurodegenerative disease
- 10 MRS in traumatic brain injury
- 11 MRS in cerebral metabolic disorders
- 12 MRS in prostate cancer
- 13 MRS in breast cancer
- 14 MRS in musculoskeletal disease
- Index
- References
14 - MRS in musculoskeletal disease
Published online by Cambridge University Press: 04 August 2010
- Frontmatter
- Contents
- Preface
- Acknowledgments
- Abbreviations
- 1 Introduction to MR spectroscopy in vivo
- 2 Pulse sequences and protocol design
- 3 Spectral analysis methods, quantitation, and common artifacts
- 4 Normal regional variations: brain development and aging
- 5 MRS in brain tumors
- 6 MRS in stroke and hypoxic–ischemic encephalopathy
- 7 MRS in infectious, inflammatory, and demyelinating lesions
- 8 MRS in epilepsy
- 9 MRS in neurodegenerative disease
- 10 MRS in traumatic brain injury
- 11 MRS in cerebral metabolic disorders
- 12 MRS in prostate cancer
- 13 MRS in breast cancer
- 14 MRS in musculoskeletal disease
- Index
- References
Summary
Key points
31P-MRS allows the detection of phosphate-containing metabolites that are central to energy metabolism, and therefore is particularly suitable for studying muscle physiology and its disorders in vivo.
Time-resolved signals from inorganic phosphates, phosphocreatine, phosphodiesters/monoesters, and intermediates of ATP reflect physiologic changes in muscles during rest, exercise, and recovery.
Quantitative analysis of metabolites allows estimates of cytosolic ADP based on a number of assumptions, and the recovery of ADP has been used as a measure of in vivo mitochondrial function.
In pathologic states including metabolic (mitochondrial or glycolytic pathway) dysfunction, hereditary and acquired myopathies, 31P-MRS shows biochemical alterations (reduced PCr, increased Pi, slow ADP recovery) that tend to overlap between pathologies.
Glycogenolytic disorders (such as McArdle's disease) may show paradoxical alkalosis during exercise.
Muscle 31P-MRS is valuable in monitoring therapeutic response in a number of neuromuscular disorders.
1H-MRS currently has a limited role in the clinical evaluation of musculoskeletal disease, but has been used as a research tool to assess intramyocellular lipid, which has been implicated in skeletal muscle insulin resistance and type 2 diabetes mellitus.
Introduction
Magnetic resonance spectroscopy (MRS) of skeletal muscle has been studied over several decades. In particular, muscle MRS has been utilized to study carbohydrate metabolism (by 13-carbon (13C) MRS), lipid metabolism (by proton (1H) MRS) and, more widely, energy metabolism (by 31-phosphorus (31P) MRS).
- Type
- Chapter
- Information
- Clinical MR SpectroscopyTechniques and Applications, pp. 243 - 255Publisher: Cambridge University PressPrint publication year: 2009