急性和亚急性脑梗死的代谢变化：质子磁共振波谱成像的发现

Metabolic changes in acute and subacute cerebral infarctions: findings at proton MR spectroscopic imaging.

作者信息

Lanfermann H, Kugel H, Heindel W, Herholz K, Heiss W D, Lackner K

机构信息

Department of Diagnostic Radiology, University of Cologne, Germany.

出版信息

Radiology. 1995 Jul;196(1):203-10. doi: 10.1148/radiology.196.1.7784568.

DOI:10.1148/radiology.196.1.7784568

PMID:7784568

Abstract

PURPOSE

To analyze the advantages of proton magnetic resonance (MR) spectroscopic imaging in the evaluation of acute and subacute cerebral infarcts.

MATERIALS AND METHODS

Metabolite maps of choline-containing compounds, total creatine consisting of creatine and phosphocreatine, N-acetyl aspartate (NAA), and lactate were obtained in 23 patients with acute and subacute cerebral infarctions 1-35 days after onset of symptoms. Maps were obtained with a 1.5-T MR system with 32 x 32 phase-encoding steps.

RESULTS

Distinct abnormal metabolite distributions could be detected in all lesions larger than 1 cm in diameter. In the center of infarcts with a diameter larger than the section thickness of 2 cm, NAA values decreased to 20% +/- 8 compared with contralateral brain as early as 1 day after onset of symptoms (P < .0001). Choline was reduced to 67% +/- 30 (not significant) and creatine to 51% +/- 22 (P = .0025). Large amounts of lactate were detected in all acute infarcts. Choline, creatine, and lactate values declined during the first 5 weeks after stroke.

CONCLUSION

MR spectroscopic imaging allows visualization of metabolic changes in stroke with a reasonable spatial resolution.

摘要

目的

分析质子磁共振（MR）波谱成像在评估急性和亚急性脑梗死中的优势。

材料与方法

对23例急性和亚急性脑梗死患者在症状出现后1至35天内获取含胆碱化合物、由肌酸和磷酸肌酸组成的总肌酸、N-乙酰天门冬氨酸（NAA）和乳酸的代谢物图谱。图谱通过具有32×32相位编码步骤的1.5-T MR系统获得。

结果

在所有直径大于1 cm的病灶中均可检测到明显的异常代谢物分布。在直径大于2 cm（切片厚度）的梗死灶中心，与对侧脑相比，NAA值在症状出现后1天就降至20%±8（P<.0001）。胆碱降至67%±30（无统计学意义），肌酸降至51%±22（P =.0025）。在所有急性梗死灶中均检测到大量乳酸。卒中后的前5周内，胆碱、肌酸和乳酸值下降。