脑梗死中质子磁共振波谱的纵向变化

Longitudinal changes in proton magnetic resonance spectroscopy in cerebral infarction.

作者信息

Houkin K, Kamada K, Kamiyama H, Iwasaki Y, Abe H, Kashiwaba T

机构信息

Department of Neurosurgery, Hokkaido University, Sapporo, Japan.

出版信息

Stroke. 1993 Sep;24(9):1316-21. doi: 10.1161/01.str.24.9.1316.

DOI:10.1161/01.str.24.9.1316

PMID:8362424

Abstract

BACKGROUND AND PURPOSE

Proton magnetic resonance spectroscopy has revealed changes in lactate and N-acetyl-aspartate in acute cerebral infarction. However, the details of these drastic changes and subsequent chronic changes have not been clarified. The purpose of this study was to disclose longitudinal changes in spectra seen in proton magnetic resonance spectroscopy.

METHODS

Six patients with completed cerebral infarction were examined longitudinally with localized proton magnetic resonance spectroscopy.

RESULTS

(1) In the acute stage (within 2 days after onset), two drastic changes were observed: N-acetyl-aspartate decreased rapidly and severely within 2 days after onset, and lactate increased immediately and reached a high level in the acute stage after onset. (2) In the chronic stage (more than 1 month after onset), two features were observed: lactate, which had increased in the acute stage, remained high for more than 1 month, and other signals such as those of N-acetyl-aspartate, choline, and phosphocreatine/creatine decreased dramatically.

CONCLUSIONS

These results suggest that N-acetyl-aspartate and lactate as revealed by proton magnetic resonance spectroscopy can be useful indicators of the ischemic damage to the brain in clinical cases of cerebral infarction.

摘要

背景与目的

质子磁共振波谱已揭示急性脑梗死中乳酸和N-乙酰天门冬氨酸的变化。然而，这些剧烈变化及随后的慢性变化细节尚未阐明。本研究的目的是揭示质子磁共振波谱中所见波谱的纵向变化。

方法

对6例完全性脑梗死患者进行局部质子磁共振波谱的纵向检查。

结果

（1）在急性期（发病后2天内），观察到两个剧烈变化：发病后2天内N-乙酰天门冬氨酸迅速且严重降低，乳酸立即升高并在发病后的急性期达到高水平。（2）在慢性期（发病后1个月以上），观察到两个特征：急性期升高的乳酸在1个月以上仍保持高水平，而其他信号如N-乙酰天门冬氨酸、胆碱和磷酸肌酸/肌酸的信号则显著降低。