Hattingen E, Lanfermann H, Menon S, Neumann-Haefelin T, de Rochement R DuMesnil, Stamelou M, Höglinger G U, Magerkurth J, Pilatus U
Institute of Neuroradiology, Johann Wolfgang Goethe University of Frankfurt/Main, Frankfurt/Main, Germany.
MAGMA. 2009 Feb;22(1):43-52. doi: 10.1007/s10334-008-0148-9. Epub 2008 Oct 15.
To evaluate if combined (1)H and (31)P MR spectroscopic imaging (MRSI) before and after treatment of severe internal carotid artery (ICA) stenosis detects significant changes in energy metabolism in the basal ganglia of both hemispheres.
A group of 14 patients with high-grade ICA stenosis and 11 healthy control subjects were examined with 2D (1)H MRSI and 3D (31)P MRSI at 3 T before and after treatment of severe ICA stenosis. Spectroscopic data were processed with LCModel and jMRUI software. Changes of the phosphorylated metabolites, pH, N-acetyl-acetate, creatine and choline-containing compounds prior/post intervention were analyzed and patients' data were compared with that of control subjects.
Untreated patients had significantly higher Adenosindiphosphate (ADP) in basal ganglia ipsi- and contralateral to the side of ACI stenosis compared to controls. After treatment, ADP of both hemispheres significantly decreased by approximately 20% compared to the pre-treatment values. Further, significant decreases of phosphorylated metabolites prior/post intervention were found for patients compared to controls.
This spectroscopic study reveals that unilateral high-grade ICA stenosis has an effect on cerebral high-energy metabolism of both hemispheres, which is at least partially reversible after treatment. Therefore the restoration of blood flow in high-grade ICA stenosis recovers the impaired energy balance of the brain.
评估在重度颈内动脉（ICA）狭窄治疗前后联合使用氢质子（¹H）和磷-31（³¹P）磁共振波谱成像（MRSI）是否能检测到双侧基底节能量代谢的显著变化。
一组14例重度ICA狭窄患者和11例健康对照者在重度ICA狭窄治疗前后接受3T场强下的二维¹H MRSI和三维³¹P MRSI检查。使用LCModel和jMRUI软件处理波谱数据。分析干预前后磷酸化代谢物、pH值、N-乙酰乙酸、肌酸和含胆碱化合物的变化，并将患者数据与对照者数据进行比较。
与对照组相比，未经治疗的患者在ACI狭窄侧同侧和对侧基底节中的二磷酸腺苷（ADP）显著更高。治疗后，与治疗前相比，双侧半球的ADP显著降低约20%。此外，与对照组相比，患者干预前后磷酸化代谢物显著降低。
这项波谱研究表明，单侧重度ICA狭窄对双侧半球的脑高能代谢有影响，治疗后这种影响至少部分可逆。因此，重度ICA狭窄时血流的恢复可恢复受损的脑能量平衡。
