Felber S R, Aichner F T, Sauter R, Gerstenbrand F
Department of Magnetic Resonance, University of Innsbruck, Austria.
Stroke. 1992 Aug;23(8):1106-10. doi: 10.1161/01.str.23.8.1106.
The prospect for a therapeutic window for treatment of ischemic stroke encourages the noninvasive investigation of metabolic changes in acute ischemia. Recently, localized proton spectroscopy became available at 1.5-T magnetic resonance systems. In this study we evaluated the usefulness of combined magnetic resonance imaging and spectroscopy on the diagnosis of acute and chronic infarctions.
Combined magnetic resonance imaging and spectroscopy investigations were carried out with a 1.5-T system in 16 volunteers, eight patients with chronic infarction (greater than 8 months), and 10 patients with acute ischemic stroke (less than 8 hours). We used a stimulated echo sequence to acquire localized spectra from image-guided volumes of interest (16-27 ml).
There were no significant interindividual differences of choline, creatine, phosphocreatine, and N-acetyl aspartate resonances in the spectra from volunteers. In chronic infarctions, N-acetyl aspartate was decreased in relation to choline. Acute ischemic infarctions were characterized by decreased N-acetyl aspartate resonances and elevation of lactate.
The study demonstrates the feasibility of proton spectroscopy in stroke patients. Metabolic alterations in ischemic tissue can be monitored and can distinguish acute from chronic lesions.
缺血性脑卒中治疗存在治疗窗的前景促使人们对急性缺血时的代谢变化进行无创性研究。近来，1.5-T磁共振系统已可进行局部质子波谱分析。在本研究中，我们评估了磁共振成像与波谱分析相结合在诊断急性和慢性梗死中的作用。
使用1.5-T系统对16名志愿者、8例慢性梗死患者（病程大于8个月）和10例急性缺血性脑卒中患者（病程小于8小时）进行磁共振成像与波谱分析联合检查。我们采用刺激回波序列从图像引导的感兴趣区（16-27毫升）获取局部波谱。
志愿者波谱中的胆碱、肌酸、磷酸肌酸和N-乙酰天门冬氨酸共振峰无显著个体间差异。在慢性梗死中，N-乙酰天门冬氨酸相对于胆碱减少。急性缺血性梗死的特征是N-乙酰天门冬氨酸共振峰降低和乳酸升高。
本研究证明了质子波谱分析在脑卒中患者中的可行性。缺血组织中的代谢改变可被监测，且能区分急性与慢性病变。
