Thorsen Thomas M, Bøgh Nikolaj, Bertelsen Lotte B, Hansen Esben S S, Laustsen Christoffer
The MR Research Centre, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
NMR Biomed. 2025 Jan;38(1):e5306. doi: 10.1002/nbm.5306.
Mild traumatic brain injuries (TBIs) are frequent in the European population. The pathophysiological changes after TBI include metabolic changes, but these are not observable using current clinical tools. We aimed to evaluate multinuclear MRI as a mean of assessing these changes. In our model, pigs were exposed to a controlled cortical impact (CCI) directly on the dura and scanned at 2 h and 2 days after injury. A multinuclear MRI protocol was used. It included hyperpolarized [1-C]pyruvate MRI, which allows depiction of hyperpolarized carbon-13, through its metabolism from pyruvate to lactate or bicarbonate. At Day 2, cerebral microdialysis were performed, and tissue was obtained for analyses. At Day 0, the cerebral blood flow was reduced in the affected hemisphere (TBI: 31.7 mL/100 mL/min, contralateral: 35.6 mL/100 mL/min, p = 0.1227), and the impacted area showed reduced oxygenation (R*, TBI: 33.11 s, contralateral: 22.20 s, p = 0.035). At both days, the lactate-to-pyruvate ratios (hyperpolarized [1-C]pyruvate) were increased (Day 0: p = 0.023, Day 2: p = 0.022). However, this study can only evaluate the total injury and, thus, cannot differentiate effects from craniotomy and CCI. This metabolic difference was not found using cerebral microdialysis nor a lactate dehydrogenase (LDH) activity assay. The metabolic changes depicted in this study contributes to our understanding of mild TBI; however, the clinical potential of multinuclear MRI is yet to be determined.
轻度创伤性脑损伤（TBI）在欧洲人群中很常见。TBI后的病理生理变化包括代谢变化，但使用目前的临床工具无法观察到这些变化。我们旨在评估多核磁共振成像（MRI）作为评估这些变化的一种手段。在我们的模型中，猪直接在硬脑膜上接受可控皮质撞击（CCI），并在受伤后2小时和2天进行扫描。使用了多核MRI方案。它包括超极化[1-C]丙酮酸MRI，通过其从丙酮酸到乳酸或碳酸氢盐的代谢来描绘超极化的碳-13。在第2天，进行脑微透析，并获取组织进行分析。在第0天，患侧半球的脑血流量减少（TBI：31.7 mL/100 mL/min，对侧：35.6 mL/100 mL/min，p = 0.1227），撞击区域的氧合减少（R*，TBI：33.11 s，对侧：22.20 s，p = 0.035）。在这两天，乳酸与丙酮酸的比率（超极化[1-C]丙酮酸）均升高（第0天：p = 0.023，第2天：p = 0.022）。然而，本研究只能评估总的损伤情况，因此无法区分开颅手术和CCI的影响。使用脑微透析或乳酸脱氢酶（LDH）活性测定未发现这种代谢差异。本研究中描绘的代谢变化有助于我们理解轻度TBI；然而，多核MRI的临床潜力尚未确定。
