The Clinical Value Research Of Mitochondrial (Encephalopathy) Myopathy Magnetic Resonance Spectroscopy

Objective: To investigate the31P magnetic resonance spectroscopy (³¹P-MRS)manifestations of skeletal muscle and the1H magnetic resonance spectroscopy(¹H-MRS) manifestationsin of craniocerebral in patients with mitochondrial(encephalopathy)myopathy and evaluate its clinical value in diagnosis.Methods: Let eight cases of mitochondrial(encephalopathy)myopathy patientsand ten controls underwent the31P-MRS scanning in resting state of the skeletalmuscle in order to obtain the spectral images (two patients were reexamined afterhaving shown signs of improvement with the treatment).Calculate the spectrum ofinorganic phosphate (Pi), creatine phosphate (PCr) and adenosine triphosphate (ATP)area under the peak, recording the ratio of Pi/ATP, PCr/ATP and Pi/PCr, calculate theintracellular pH value (PHint) and phosphorylation potential (PP) of Pi, PCr,adenosine diphosphate (ADP) and other measures of the parameter value ofmitochondria functions, and also compare the differences of31P-MRS index of themitochondrial (encephalopathy)myopathy patients and the controls. Five patientsand three cases in the control group performed the1H-MRS scan in order to observethe changes in patients of mitochondrial(encephalopathy)myopathy with N-acetylaspartate (NAA) peak and lactate (Lac) peak.Results:(1) Compared with the control group, mitochondrial (encephalopathy)myopathy patients had significantly lower PP (P<0.05), and significantly higher Pi,Pi/ATPand Pi/PCr (P<0.05), but there were no significant differences in PCr,PCrATP,PHintand ADP between the control group and patients (P>0.05).(2) The1H-MRS scan of five mitochondrial (encephalopathy)myopathy patients show thedifferent degree of decline of NAA and three patients of MELAS had significantLac, the patient of mitochondrial myopathy had obvious Lac but the Lac of thepatient of CPEO was not obvious.Conclusion：Both the³¹P-MRS and¹H-MRS can monitor the variations ofenergetic metabolism inmitochondrial (encephalopathy) myopathy patientsnoninvasively, which is very useful for the auxiliary diagnosis and may improve the diagnostic accuracy of the disease with both.