T2*-weighted and arterial spin labeling MRI of calf muscles in healthy volunteers and patients with chronic exertional compartment syndrome: preliminary experience.

Full Abstract

OBJECTIVE: The purpose of our study was to assess temporal changes with exercise in T2* and arterial spin labeling signals in patients with chronic exertional compartment syndrome of the anterior compartment of the lower leg and in control subjects using T2* mapping and arterial spin labeling MRI. SUBJECTS AND METHODS: This prospective study was approved by the institutional research ethics board. Ten control subjects (five women and five men; mean age, 29.0 years) and nine patients with chronic exertional compartment syndrome (three women and six men; mean age, 33.7 years) gave informed written consent and underwent MRI of the calf muscles using an axial T2*-weighted multiecho gradient-recalled echo and a flow-sensitive alternating inversion recovery sequence with echo-planar imaging readouts before (baseline) and 3, 6, 9, 12, and 15 minutes after exercise. T2* and arterial spin labeling signal changes (DeltaT2* and DeltaASL, respectively) over time were calculated relative to the baseline examination. DeltaT2* and DeltaASL between patients and control subjects were compared using the Student's t test. RESULTS: In both patients and control subjects, DeltaT2* and DeltaASL showed a peak at 3 minutes after exercise, followed by a decrease over time. The maximum DeltaT2* was 26% and 29% for patients and control subjects, respectively. The maximum DeltaASL was 183% and 224% for patients and control subjects, respectively. After 15 minutes, arterial spin labeling signal returned to baseline; however, T2* remained elevated (8% in patients; 10% in control subjects). No statistically significant differences between patients and control subjects in postexercise DeltaT2* and DeltaASL were found (p = 0.21-0.98). CONCLUSION: After calf muscle exercise, no statistically significant differences in T2* relaxation times or arterial spin labeling signal, indicative of differences in muscle oxygenation and perfusion status, were found between patients with chronic exertional compartment syndrome and control subjects.

Author information

Author/s: Andreisek, Gustav (G); White, Lawrence M (LM); Sussman, Marshall S (MS); Langer, Deanna L (DL); Patel, Chirag (C); Su, Jason Wen-Shyang (JW); Haider, Masoom A (MA); Stainsby, Jeff A (JA);

Affiliation: Division of Musculoskeletal Imaging, Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, University of Toronto, Toronto, ON, Canada.

Journal and publication information

Publication Type: Journal Article

Journal: AJR. American journal of roentgenology (AJR Am J Roentgenol), published in United States. (Language: eng)

Reference: 2009-Oct; vol 193 (issue 4) : pp W327-33

Dates: Created 2009/09/22; Completed 2009/10/14;

PMID: 19770303, status: MEDLINE (last retrieval date: 10/14/2009, IMS Date: )

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