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1 Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan - Republic of China
2 Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
3 Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, United States; Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
4 Vascular Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
5 Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
6 Anesthesiology and Critical Care, Hospital of University of Pennsylvania, Philadelphia, Pennsylvania, United States
* To whom correspondence should be addressed. E-mail: thomas.floyd{at}uphs.upenn.edu.
Arterial spin labeling (ASL) is a noninvasive magnetic resonance imaging (MRI) technique for microvascular blood flow measurement. We use a continuous ASL scheme (CASL) to investigate the hyperemic flow difference between major muscle groups in human extremities. Twenty-four healthy subjects with no evidence of vascular disease were recruited. MRI was conducted on a 3T whole-body system with a transmit/receive knee coil. A nonmagnetic orthopedic tourniquet system was used to create a 5-min period of ischemia followed by a period of hyperemic flow (occlusion pressure = 250 mmHg). CASL imaging lasting from 2 min before cuff inflation to 3 min after cuff deflation was performed on the mid-calf, mid-foot, and mid-forearm in separate sessions from which blood flow was quantified with an effective temporal resolution of 16 sec. When comparing muscles in the same anatomic location, hyperemic flow was found to be significantly higher in the compartments containing muscles known to have relatively higher slow-twitch type-I fiber compositions, such as the soleus muscle in the calf and the extensors in the forearm. In the foot, the plantar flexors exhibited a slightly delayed hyperemic response relative to that of the dorsal compartment but no between-group flow difference was observed. These results demonstrate that CASL is sensitive to flow heterogeneity between diverse muscle groups and that nonuniform hyperemic flow patterns following an ischemic paradigm correlate with relative fiber type predominance.
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