High-voltage electric injury: Assessment of muscle viability with MR imaging and Tc-99m pyrophosphate scintigraphy

J. L. Fleckenstein, D. P. Chason, F. J. Bonte, R. W. Parkey, J. L. Hunt, G. F. Purdue, D. K. Burns

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

PURPOSE: To evaluate use of magnetic resonance (MR) imaging and technetium-99m pyrophosphate (PYP) scintigraphy in preoperative assessment of muscle viability after high-voltage electric injury. MATERIALS AND METHODS: Twelve injured limbs were studied. Immediate, equilibrium, and delayed Tc- 99m PYP scintigrams and gadolinium-enhanced and unenhanced MR images were obtained. Imaging results were compared with clinical findings. RESULTS: Scintigraphy demonstrated nonperfusion in four limbs that were subsequently amputated, but MR imaging had poor sensitivity in nonperfused regions owing to lack of edema. Tc-99m PYP uptake increased at transition zones between normal and nonperfused regions. MR imaging allowed further characterization of these zones by demonstrating edema as enhancing (perfused) or nonenhancing (nonperfused). In all nonamputated limbs, edema showed enhancement. CONCLUSION: In high-voltage electric injury, gadolinium-enhanced MR imaging appears able to demonstrate zones of potential viability within radionuclide- avid tissue but has poor perfusion sensitivity when used alone.

Original languageEnglish (US)
Pages (from-to)205-210
Number of pages6
JournalRadiology
Volume195
Issue number1
StatePublished - 1995

Fingerprint

Electric Injuries
Technetium Tc 99m Pyrophosphate
Radionuclide Imaging
Magnetic Resonance Imaging
Muscles
Edema
Extremities
Gadolinium
Technetium
Radioisotopes
Magnetic Resonance Spectroscopy
Perfusion

Keywords

  • Electric injury
  • Extremities, injuries
  • Extremities, radionuclide studies
  • Muscles, injuries
  • Muscles, radionuclide studies

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Fleckenstein, J. L., Chason, D. P., Bonte, F. J., Parkey, R. W., Hunt, J. L., Purdue, G. F., & Burns, D. K. (1995). High-voltage electric injury: Assessment of muscle viability with MR imaging and Tc-99m pyrophosphate scintigraphy. Radiology, 195(1), 205-210.

High-voltage electric injury : Assessment of muscle viability with MR imaging and Tc-99m pyrophosphate scintigraphy. / Fleckenstein, J. L.; Chason, D. P.; Bonte, F. J.; Parkey, R. W.; Hunt, J. L.; Purdue, G. F.; Burns, D. K.

In: Radiology, Vol. 195, No. 1, 1995, p. 205-210.

Research output: Contribution to journalArticle

Fleckenstein, JL, Chason, DP, Bonte, FJ, Parkey, RW, Hunt, JL, Purdue, GF & Burns, DK 1995, 'High-voltage electric injury: Assessment of muscle viability with MR imaging and Tc-99m pyrophosphate scintigraphy', Radiology, vol. 195, no. 1, pp. 205-210.
Fleckenstein, J. L. ; Chason, D. P. ; Bonte, F. J. ; Parkey, R. W. ; Hunt, J. L. ; Purdue, G. F. ; Burns, D. K. / High-voltage electric injury : Assessment of muscle viability with MR imaging and Tc-99m pyrophosphate scintigraphy. In: Radiology. 1995 ; Vol. 195, No. 1. pp. 205-210.
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AB - PURPOSE: To evaluate use of magnetic resonance (MR) imaging and technetium-99m pyrophosphate (PYP) scintigraphy in preoperative assessment of muscle viability after high-voltage electric injury. MATERIALS AND METHODS: Twelve injured limbs were studied. Immediate, equilibrium, and delayed Tc- 99m PYP scintigrams and gadolinium-enhanced and unenhanced MR images were obtained. Imaging results were compared with clinical findings. RESULTS: Scintigraphy demonstrated nonperfusion in four limbs that were subsequently amputated, but MR imaging had poor sensitivity in nonperfused regions owing to lack of edema. Tc-99m PYP uptake increased at transition zones between normal and nonperfused regions. MR imaging allowed further characterization of these zones by demonstrating edema as enhancing (perfused) or nonenhancing (nonperfused). In all nonamputated limbs, edema showed enhancement. CONCLUSION: In high-voltage electric injury, gadolinium-enhanced MR imaging appears able to demonstrate zones of potential viability within radionuclide- avid tissue but has poor perfusion sensitivity when used alone.

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