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@ARTICLE{Weber:130829,
      author       = {M.-A. Weber$^*$ and A. Nagel$^*$ and A. Marschar$^*$ and P.
                      A. Glemser$^*$ and K. Jurkat-Rott and M. B. Wolf$^*$ and M.
                      Ladd$^*$ and H.-P. Schlemmer$^*$ and H.-U. Kauczor and F.
                      Lehmann-Horn},
      title        = {7-{T} (35){C}l and (23){N}a {MR} {I}maging for {D}etection
                      of {M}utation-dependent {A}lterations in {M}uscular {E}dema
                      and {F}at {F}raction with {S}odium and {C}hloride
                      {C}oncentrations in {M}uscular {P}eriodic {P}aralyses.},
      journal      = {Radiology},
      volume       = {280},
      number       = {3},
      issn         = {1527-1315},
      address      = {Oak Brook, Ill.},
      publisher    = {Soc.},
      reportid     = {DKFZ-2017-05907},
      pages        = {848 - 859},
      year         = {2016},
      abstract     = {Purpose To determine whether altered sodium (Na(+)) and
                      chloride (Cl(-)) homeostasis can be visualized in periodic
                      paralyses by using 7-T sodium 23 ((23)Na) and chlorine 35
                      ((35)Cl) magnetic resonance (MR) imaging. Materials and
                      Methods Institutional review board approval and informed
                      consent of all participants were obtained. (23)Na
                      (repetition time msec/echo time msec, 160/0.35) and (35)Cl
                      (40/0.6) MR imaging of both lower legs was performed with a
                      7-T whole-body system in patients with genetically confirmed
                      hypokalemic periodic paralysis (Cav1.1-R1239H mutation, n =
                      5; Cav1.1-R528H mutation, n = 8) and Andersen-Tawil syndrome
                      (n = 3) and in 16 healthy volunteers. Additionally, each
                      participant underwent 3-T proton MR imaging on the same day
                      by using T1-weighted, short-tau inversion-recovery, and
                      Dixon-type sequences. Muscle edema was assessed on short-tau
                      inversion-recovery images, fatty degeneration was assessed
                      on T1-weighted images, and muscular fat fraction was
                      quantified with Dixon-type imaging. Na(+) and Cl(-) were
                      quantified in the soleus muscle by using three phantoms that
                      contained 10-, 20-, and 30-mmol/L NaCl solution and $5\%$
                      agarose gel as a reference. Parametric data for all
                      subpopulations were tested by using one-way analysis of
                      variance with the Dunnett test, and correlations were
                      assessed with the Spearman rank correlation coefficient.
                      Results Median muscular (23)Na concentration was higher in
                      patients with Cav1.1-R1239H (34.7 mmol/L, P < .001),
                      Cav1.1-R528H (32.0 mmol/L, P < .001), and Kir2.1 (24.3
                      mmol/L, P = .035) mutations than in healthy volunteers (19.9
                      mmol/L). Median muscular normalized (35)Cl signal intensity
                      was higher in patients with Cav1.1-R1239H (27.6, P < .001)
                      and Cav1.1-R528H (23.6, P < .001) than in healthy volunteers
                      (12.6), but not in patients with the Kir2.1 mutation (14.3,
                      P = .517). When compared with volunteers, patients with
                      Cav1.1-R1239H and Cav1.1-R528H showed increased muscular
                      edema (P < .001 and P = .003, respectively) and muscle fat
                      fraction (P < .001 and P = .017, respectively). Conclusion
                      With 7-T MR imaging, changes of Na(+) and Cl(-) homeostasis
                      can be visualized in periodic paralyses and are most
                      pronounced in the severe phenotype Cav1.1-R1239H, with up to
                      daily paralytic episodes. (©) RSNA, 2016 An earlier
                      incorrect version of this article appeared online. This
                      article was corrected on April 18, 2016.},
      keywords     = {Sodium Isotopes (NLM Chemicals) / Chlorine (NLM Chemicals)},
      cin          = {E010 / E020 / E015},
      ddc          = {610},
      cid          = {I:(DE-He78)E010-20160331 / I:(DE-He78)E020-20160331 /
                      I:(DE-He78)E015-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:27082780},
      doi          = {10.1148/radiol.2016151617},
      url          = {https://inrepo02.dkfz.de/record/130829},
}