Berkelbach van der Sprenkel J W, Luyten P R, van Rijen P C, Tulleken C A, den Hollander J A
Department of Neurosurgery, University Hospital, Utrecht, The Netherlands.
Stroke. 1988 Dec;19(12):1556-60. doi: 10.1161/01.str.19.12.1556.
Water-suppressed image-guided localized proton magnetic resonance spectroscopy was performed in a 59-year-old woman with two major brain infarcts. Spectra were measured in the infarcts, in an area between the infarcts, and in the healthy hemisphere. The volumes of interest were selected on the basis of a fast T2-weighted image. A 1331-2662 Hahn spin-echo sequence was used to suppress the water in the 8-cm3 volume that was selected by means of spatially resolved spectroscopy or stimulated echoes. The spectra were obtained in 5 minutes' accumulation time. Spectral editing was applied to separate the resonance of lactate from that of other substances. Our results show no increase of lactate concentration within the infarcts after 6 months; however, a resonance was observed at 1.6 ppm, which is assigned to fatty acids. Peak intensities of brain-specific compounds were decreased. Six months after the onset of clinical symptoms (at the time of bypass surgery), a fivefold increase in lactate concentration compared with normal values was observed in the area between the two infarcts. Four months after bypass surgery, the lactate concentration in this area had decreased to only twice normal. We speculate that lactate is a marker of reversible or impending brain damage.
对一名患有两处严重脑梗死的59岁女性进行了水抑制图像引导的局部质子磁共振波谱分析。在梗死灶、梗死灶之间的区域以及健康半球测量波谱。感兴趣的体积基于快速T2加权图像选择。使用1331 - 2662哈恩自旋回波序列抑制通过空间分辨波谱或受激回波选择的8立方厘米体积内的水。在5分钟的累积时间内获得波谱。应用谱编辑将乳酸的共振与其他物质的共振分开。我们的结果显示，6个月后梗死灶内乳酸浓度没有增加；然而，在1.6 ppm处观察到一个共振，归属于脂肪酸。脑特异性化合物的峰值强度降低。临床症状出现6个月后（在搭桥手术时），在两处梗死灶之间的区域观察到乳酸浓度比正常值增加了五倍。搭桥手术后4个月，该区域的乳酸浓度已降至仅为正常值的两倍。我们推测乳酸是可逆或即将发生的脑损伤的标志物。
