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[Definition of a diagnostic score of malignant hyperthermia using P-31 magnetic resonance spectroscopy]
D Bendahan1, G Kozak-Ribbens, S Confort-Gouny
1Centre de résonance magnétique biologique et médicale (URA-CNRS 1186), faculté de médecine, Marseille, France.
Objectives:
To assess the metabolic muscular disorders associated with malignant hyperthermia (MH) using 31-P MRS, in order to develop a diagnostic tool for MH.
Study Design:
Retrospective analysis of a series of case.
Patients:
Group of 39 subjects, including 13 MH susceptible (MHS), and 26 not susceptible (MHN) members of recognized MHS families, according to the results of the in vitro contracture tests.
Methods:
Each subject underwent two protocols, both including rest, exercise and recovery periods. Exercise was performed successively under aerobic and ischaemic conditions.
Results And Discussion:
A significant early acidosis was recorded for the MHS group under both conditions of exercise (normoxia and ischaemia). However, the sensitivity of this parameter (77%) was not high enough to be considered as discriminant. Therefore a MRS score has been defined, corresponding to the sum of metabolic anomalies (acidosis, anomalies in PCr tum-over and in ATP or phosphomonoesters concentrations) recorded throughout both protocols. This score provided satisfactory results for both sensitivity (93%) and specificity (93%).
Conclusion:
31-P MRS can act as a reliable diagnostic tool for MH.