Korean J Radiol.  2009 Dec;10(6):581-586. 10.3348/kjr.2009.10.6.581.

Changes in Muscular Lipids in Unilateral Isolated Hypertrophy of Gastrocnemius Muscle Can Be Revealed by 1H MR Spectroscopy

• Brechtel K
• Machann J
• Pick M
• Schaefer J
• Claussen C
• Schick F

• KMID: 1102561
• DOI: http://doi.org/10.3348/kjr.2009.10.6.581

Abstract

OBJECTIVE
To test whether proton magnetic resonance spectroscopy (1H-MRS) reveals changes in the lipid content of the gastrocnemius muscle (GM) and soleus muscle (SOL) of a patient with unilateral isolated hypertrophy of the right GM. MATERIALS AND METHODS: 1H-MRS was performed on a 1.5 Tesla (T) whole-body unit. Muscular lipids inside SOL and GM were assessed in both calves of the patient by a STEAM (stimulated echo acquisition mode) localization sequence. Results were compared to a control group of four healthy volunteers. RESULTS: Total amount of muscular lipids in the hypertrophic GM of the patient was clearly increased compared to the controls (38.7 versus 21.8+/-3.5 a.u.) while intramyocellular lipids of the adjacent SOL were lower compared to the contralateral healthy leg. CONCLUSION: Muscular lipids are substrates for metabolism and can be assessed non-invasively by 1H-MRS. 1H-MRS is considered to be a helpful tool in clinical assessment of muscle metabolism in cases with muscular hypo- or hypertrophy.

Keyword

EMCL; Muscle hypertrophy; Magnetic resonance spectroscopy; Extramyocellular lipids; Intramyocellular lipids

MeSH Terms

Adolescent
Adult
Case-Control Studies
Female
Humans
Hypertrophy/metabolism
Leg/pathology
*Lipid Metabolism
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy/*methods
Muscle, Skeletal/*metabolism/pathology

Figure

• 

  Fig. 1 Axial T1-weighted image of lower legs performed in 13-year-old girl with unilateral hypertrophy of right calf. Right medial gastrocnemius muscle is hypertrophic, lateral portion shows slight augmentation. White boxes indicate voxel positions for spectroscopic examinations. A = right medial gastrocnemius muscle (GM), B = left GM, C = right soleus muscle (SOL), D = left SOL.

• 

  Fig. 2 1H-MRS of right (A) and left (B) GM and right (C) and left (D) SOL performed in 13-year-old girl with unilateral hypertrophy of right calf. Signals are indicated in C as Chol (choline; 3.4 ppm), Crea (creatine; 3.15 ppm), IMCL (intramyocellular lipids; 1.3-1.5 ppm), and EMCL (extramyocellular lipids; 1.5-1.7 ppm). Spectra are referenced on creatine signal of each muscle. Signal intensities are given in arbitrary units as usual in 1H-MRS. GM = gastrocnemius muscle, SOL = soleus muscle

• 

  Fig. 3 Comparison of total muscle lipid ratio between gastrocnemius muscle and soleus muscle, for normal controls (white diamonds) and patient (grey hexagons). Mean value of normal controls is indicated as black dot with 95%-intervals as error bars. Total muscle lipid-ratio of patient's right leg (with gastrocnemius muscle hypertrophy) is clearly above normal range. TML = total muscle lipid

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