23Na MRI Depicts Early Changes in Ion Homeostasis in Skeletal Muscle Tissue of Patients With Duchenne Muscular Dystrophy
Gerhalter T, Gast L, Marty B, Martin J, Trollmann R, Schüssler S, Roemer F, Uder M, Schröder R, Carlier PG, Nagel AM, Laun FB (2019)
Publication Type: Journal article
Publication year: 2019
Journal
Book Volume: 50
Pages Range: 1103-1113
Journal Issue: 4
DOI: 10.1002/jmri.26681
Abstract
BACKGROUND: Duchenne muscular dystrophy (DMD) is a hereditary neuromuscular disease leading to progressive muscle wasting. Since there is a need for MRI variables that serve as early sensitive indicators of response to treatment, several quantitative MRI methods have been suggested for disease monitoring. PURPOSE: To evaluate the potential of sodium (23 Na) and proton (1 H) MRI methods to assess early pathological changes in skeletal muscle of DMD. STUDY TYPE: Prospective clinical study. POPULATION: 23 Na and 1 H MRI of the right leg were performed in 13 patients with DMD (age 7.8 ± 2.4) and 14 healthy boys (age 9.5 ± 2.2). FIELD STRENGTH/SEQUENCE: 3 T including a multiecho-spin-echo sequence, diffusion-weighted sequences, 1 H spectroscopy, 3-pt Dixon, and 23 Na ultrashort echo time sequences. ASSESSMENT: We obtained water T2 maps, fat fraction (FF), pH, and diffusion properties of the skeletal muscle tissue. Moreover, total tissue sodium concentration (TSC) was calculated from the 23 Na sequence. Intracellular-weighted 23 Na signal (ICwS) was derived from 23 Na inversion-recovery imaging. STATISTICAL TESTS: Results from DMD patients and controls were compared using Wilcoxon rank-sum tests and repeated analysis of variance (ANOVA). Spearman-rank correlations and area under the curve (AUC) were calculated to assess the performance of the different MRI methods to distinguish dystrophic from healthy muscle tissue. RESULTS: FF, water T2 , and pH were higher in DMD patients (0.07 ± 0.03, 39.4 ± 0.8 msec, 7.06 ± 0.03, all P < 0.05) than in controls (0.02 ± 0.01, 36.0 ± 0.4 msec, 7.03 ± 0.02). No difference was observed in diffusion properties. TSC (26.0 ± 1.3 mM, P < 0.05) and ICwS (0.69 ± 0.05 a.u., P < 0.05) were elevated in DMD (controls: 16.5 ± 1.3 mM and 0.47 ± 0.04 a.u.). The ICwS was frequently abnormal in DMD even when water T2 , FF, and pH were in the normal range. 23 Na MRI showed higher AUC values in comparison to the 1 H methods. DATA CONCLUSION: Sodium anomalies were regularly observed in patients with DMD compared with controls, and were present even in absence of fatty degenerative changes and water T2 increases. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1103-1113.
Authors with CRIS profile
Lena Gast
Institute of Radiology
Regina Trollmann
Professur für Kinder- u. Jugendmedizin Schwerpunkt Neuropädiatrie
Frank Roemer
Institute of Radiology
Michael Uder
Lehrstuhl für Diagnostische Radiologie
Rolf Schröder
Professur für Neuropathologie
Armin Michael Nagel
Professur für metabolische und funktionelle MR-Bildgebung
Frederik Bernd Laun
Professur für quantitative MR-Bildgebung (Heisenberg-Professur)
Involved external institutions
France (FR)How to cite
APA:
Gerhalter, T., Gast, L., Marty, B., Martin, J., Trollmann, R., Schüssler, S.,... Laun, F.B. (2019). 23Na MRI Depicts Early Changes in Ion Homeostasis in Skeletal Muscle Tissue of Patients With Duchenne Muscular Dystrophy. Journal of Magnetic Resonance Imaging, 50(4), 1103-1113. https://doi.org/10.1002/jmri.26681
MLA:
Gerhalter, Teresa, et al. "23Na MRI Depicts Early Changes in Ion Homeostasis in Skeletal Muscle Tissue of Patients With Duchenne Muscular Dystrophy." Journal of Magnetic Resonance Imaging 50.4 (2019): 1103-1113.
BibTeX: Download