In vivo proton spin-lattice relaxation times of normal and dystrophic muscles

Effect of deflazacort on cardiac and sternocleidomastoid muscles in Duchenne muscular dystrophy: a magnetic resonance imaging study

OBJECTIVE

To evaluate the involvement of cardiac and sternocleidomastoid muscles by magnetic resonance imaging (MRI) measurement of T2 relaxation time and the left ventricular systolic function in patients with Duchenne muscular dystrophy (DMD) on treatment with deflazacort and compare them with DMD patients without treatment.

SUBJECTS

Seventeen patients with DMD (aged 17-22 years) on treatment with deflazacort for at least 7 years and 17 boys with DMD of younger age (12-15 years) without steroid treatment. All patients were free of cardiac or respiratory symptoms and had normal ECG and Holter monitor examination.

METHODS

T2 relaxation time of the myocardium (H), left (SCM-L) and right sternocleidomastoid (SCM-R) muscles and left ventricular systolic function were evaluated by magnetic resonance imaging (MRI) in two groups of DMD patients. Myocardial and sternocleidomastoid muscles T2 relaxation time was calculated using 16 TEs (10-85 msec) and TR at least 2000 ms and T2 maps were created.

RESULTS

DMD on deflazacort had higher T2 relaxation time values of the heart and of both sternocleidomastoid muscles (T2H median (range): 47 (41-48) vs. 33 (31-37)ms, p<0.001, T2 SCM-L median (range): 35 (30-37) vs. 23 (20-26)ms, p<0.001, T2 SCM-R median (range): 35 (32-37) vs. 23 (20-27)ms, p<0.001) and left ventricular systolic function (LVEDV median (range): 95 (75-120) vs. 90 (80-105)ml, p=0.03, LVESV median (range): 45 (38-55) vs. 47 (41-51)ml, p=0.81(NS), LVEF median (range): 53% (51-57) vs. 48% (42-51), p<0.001) compared to DMD without treatment.

CONCLUSIONS

DMD patients on deflazacort are characterized by better preservation of the T2 relaxation time of myocardium and sternocleidomastoid muscles and better LV systolic function. The duration of this beneficial effect needs to be studied prospectively.

Quantitative magnetic resonance imaging of the mdx mouse model of Duchenne muscular dystrophy

The mdx mouse has a genetically homologous disease to Duchenne muscular dystrophy in humans. The disease progression, however, is not accompanied by the same level of fatty infiltration and muscle degeneration as occurs in humans. Thus, the presence of histological/pathological changes in living mdx mice has been difficult to monitor. We quantified proton density and the T2 relaxation time of protons with a resolution of 195 x 195 x 1000 microm using multiecho magnetic resonance (MR) imaging at 7 Tesla. These relaxation data were correlated with water content in both muscle and brain of mdx and controls. No differences were observed in brain. The mdx muscles had increased water content and proton density and decreased T2 relative to controls. These data indicate that there are intrinsic changes in T2 (opposite to that which would be induced by fatty infiltration) and suggest that T2 imaging could be used to monitor progression and treatment in this animal model.

Multiexponential proton relaxation processes of compartmentalized water in gels

The proton relaxation times, T1 and T2, of water in Sephadex gels, exhibiting pores of varying size (i.e., with exclusion limits of molecular weight between 10(3) and 10(5)) and water contents in the range 30 to 70% (w/w, weight of water to total weight), were measured at 20 MHz in the temperature range 5 to 50 degrees C. Multiexponential analysis of the relaxation curves revealed the existence of two relaxation components in all gel systems. A component with long T1 and T2 (T1,1 and T2,1) is associated with a large water fraction alpha 1,1 and alpha 2,1 and a component with short T1 and T2 (T1,2 and T2,2) with a small water fraction alpha 1,2 and alpha 2,2. An analysis of the temperature behavior of the relaxation components gives insight into the relaxation mechanisms. The relaxation process in water, compartmentalized in the gel matrix, is mainly controlled by dipole-dipole interactions. In addition, proton exchange processes between hydration water and hydroxyl groups of the matrix chain contribute under specific conditions and lead to a dramatic enhancement of the relaxation rate. In particular, for gels with small pores and with low water content proton exchange is observed. Compartments of water in gels could be models for compartments of water in biological tissues.

In vivo T1 characterization of genetically induced muscle atrophy

In vivo spin-lattice relaxation times, T1, of water and lipid protons of normal and atrophic muscles were measured, using the spatially resolved spectroscopy (SPARS) sequence, in a genetic avian model of myopathy. These T1 values were compared with those of the hypertrophic muscles. Although the water T1 values of muscles were elevated in both types of lesions, the atrophic muscles showed a greater increase (54%) than the hypertrophic muscles (22%). The water T1 differentiation between the atrophic and hypertrophic muscles appeared to depend upon their bound water fractions that were calculated on the basis of the Fast Proton Diffusion model. The lipid T1 values of muscles were higher in the atrophic line of chickens compared to their genetic controls. In contrast, the lipid T1 values of muscles of the hypertrophic chickens and their controls were essentially identical. This suggests that the lipid T1 values may potentially complement the water T1 values in the differential diagnosis of muscle disorders.