Assessment of Skeletal Muscle Microperfusion Using MRI

Noninvasive measurement of lower extremity muscle oxygen extraction fraction under cuff compression paradigm

“…But some points need to be noticed when applying this cuff compression diagram in clinical diagnosis. First, fast cuff inflation is required to minimize the discomfort of patients with vascular diseases . In addition, patients with critical leg ischemia, ulceration, necrosis, or gangrene should be removed from this protocol because of the massive pain or risk of worsening of the diseases …”

“…As mentioned above, investigators in previous studies of skeletal muscle oxygenation have used cuff compression, exercise, or oxygen inhalation protocol to induce measureable alteration of oxygen consumption . In the oxygen inhalation protocol, subjects need to breathe 100% oxygen for several minutes to permit equilibration of blood gases .…”

“…Some particular fixation devices and corresponding specific radio frequency coils are usually required to reduce the motion effect. Thus, the normalization of this protocol for clinical application, especially in MR scanner, seems to be challenging . To the contrary, cuff compression paradigm is relatively independent from volunteer compliance, which reduces the motion effect to the minimum .…”

“…As mentioned above, investigators in previous studies of skeletal muscle oxygenation have used cuff compression, exercise, or oxygen inhalation protocol to induce measureable alteration of oxygen consumption. 20,21 In the oxygen inhalation protocol, subjects need to breathe 100% oxygen for several minutes to permit equilibration of blood gases. 20 In the exercise protocol including isometric contraction paradigm, volunteers are usually solicited to carry out muscle exercise, which is highly dependent on the compliance of the subjects.…”

“…21 To the contrary, cuff compression paradigm is relatively independent from volunteer compliance, which reduces the motion effect to the minimum. 21 Furthermore, this paradigm is commonly achieved by cuff compression of limb with a fixed air cuff, which facilitates the experimental setup and can be standardized in clinical application. Based on this paradigm, significant muscle tissue oxygenation alternations and consecutively excellent signal contrast have been demonstrated by former BOLD MRI studies.…”