The use of P31 magnetic resonance spectroscopy to evaluate the effect of ATP-MgCl2 perfusion on the metabolism of rat skin island flaps.

Abstract

Depleted levels of adenosine triphosphate (ATP) are described as one of the important causes of skin flap failure. This study evaluated the beneficial effects of intra-arterial perfusion of ATP-magnesium chloride (MgCl2) in ischemic neurovascular skin island flaps in the rat and observed the changes of the highenergy phosphate metabolite using phosphorus 31-(P31) magnetic resonance spectroscopy (MRS). The changes of ATP, phosphocreatine (PCr), and inorganic phosphate (Pi) were observed from P31 MRS and the ratios of each metabolite were compared. The extent of skin flap survival was assessed 7 days after operation using an image analyzer. The PCr/Pi ratio of the experimental group (ATP-MgCl2) was significantly different from the control group (balanced salt solution; p < 0.05). Furthermore, the infusion of ATP-MgCl2 (40.3%) significantly improved the area of flap survival compared to the control group (14.2%; p < 0.05). The ratios of PCr/Pi PCr/(PCr + Pi) correlated with the extent of flap survival, and correlation coefficients were 0.59 and 0.60, respectively. In conclusion, ATP-MgCl2 improved skin flap survival. We were able to assess the metabolic state of the ATP-MgCl2-perfused skin flap and found that PCr/Pi ratios correlated with flap survival.