UCLA Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Dept. of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
UCLA Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Dept. of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California Los Angeles, Los Angeles, CA, USA.
Neuroimage Clin. 2019;22:101736. doi: 10.1016/j.nicl.2019.101736. Epub 2019 Feb 25.
Cerebral acidosis is a consequence of secondary injury mechanisms following traumatic brain injury (TBI), including excitotoxicity and ischemia, with potentially significant clinical implications. However, there remains an unmet clinical need for technology for non-invasive, high resolution pH imaging of human TBI for studying metabolic changes following injury. The current study examined 17 patients with TBI and 20 healthy controls using amine chemical exchange saturation transfer echoplanar imaging (CEST EPI), a novel pH-weighted molecular MR imaging technique, on a clinical 3T MR scanner. Results showed significantly elevated pH-weighted image contrast (MTR at 3 ppm) in areas of T2 hyperintensity or edema (P < 0.0001), and a strong negative correlation with Glasgow Coma Scale (GCS) at the time of the MRI exam (R = 0.4777, P = 0.0021), Glasgow Outcome Scale - Extended (GOSE) at 6 months from injury (R = 0.5334, P = 0.0107), and a non-linear correlation with the time from injury to MRI exam (R = 0.6317, P = 0.0004). This evidence suggests clinical feasibility and potential value of pH-weighted amine CEST EPI as a high-resolution imaging tool for identifying tissue most at risk for long-term damage due to cerebral acidosis.
脑酸中毒是创伤性脑损伤 (TBI) 继发性损伤机制的结果，包括兴奋性毒性和缺血，具有潜在的重要临床意义。然而，对于 TBI 患者的非侵入性、高分辨率 pH 成像技术，仍然存在着未满足的临床需求，以便研究损伤后的代谢变化。本研究使用胺化学交换饱和传递磁共振成像（CEST EPI）对 17 例 TBI 患者和 20 例健康对照者进行了检查，这是一种新型的 pH 加权分子磁共振成像技术，在临床 3T 磁共振扫描仪上进行。结果显示，在 T2 高信号或水肿区域的 pH 加权图像对比度（3ppm 处的 MTR）显著升高（P<0.0001），与磁共振成像检查时的格拉斯哥昏迷评分（GCS）呈强烈负相关（R=0.4777，P=0.0021），与损伤后 6 个月的格拉斯哥预后评分-扩展版（GOSE）呈正相关（R=0.5334，P=0.0107），与从损伤到磁共振成像检查的时间呈非线性相关（R=0.6317，P=0.0004）。这些证据表明，pH 加权胺 CEST EPI 作为一种高分辨率成像工具，具有识别因脑酸中毒而导致长期损伤的高危组织的临床可行性和潜在价值。
