急性大脑中动脉卒中的质子磁共振波谱分析

Proton MR spectroscopy in acute middle cerebral artery stroke.

作者信息

Gillard J H, Barker P B, van Zijl P C, Bryan R N, Oppenheimer S M

机构信息

Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, Md, USA.

出版信息

AJNR Am J Neuroradiol. 1996 May;17(5):873-86.

PMID:8733962

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8337522/

Abstract

PURPOSE

To investigate the feasibility of performing multisection proton MR spectroscopy in patients with acute stroke, and to determine whether this imaging technique can depict ischemic or infarcted brain regions.

METHODS

Multisection proton MR spectroscopy, MR imaging, and MR angiography were performed within 24 hours of stroke onset (mean, 12 hours) in 12 patients who had had a stroke of the middle cerebral artery. Spectra were analyzed from brain regions containing T2 hyperintensity abnormalities on MR images, from regions immediately adjacent to these abnormalities, and from anatomically similar contralateral regions. Areas of brain containing lactate were compared with areas of T2 hyperintensities on MR images.

RESULTS

One data set was discarded because of excessive artifacts from patient motion. Regions of T2 hyperintensities on MR images were found to contain elevated lactate (all 11 cases) and reduced N-acetyl-aspartate (10 of 11 cases) relative to contralateral measurements. Lactate levels in regions adjacent to T2 hyperintensities were not significantly different from those of infarcted brain. On the other hand, N-acetyl-aspartate was significantly lower in regions of infarction compared with periinfarct tissue. Areas of brain containing elevated lactate significantly exceeded those of T2 abnormality.

CONCLUSIONS

Proton MR spectroscopy is feasible for imaging patients with acute stroke. In the early stages of stroke, tissue containing elevated lactate but no other spectroscopic or MR imaging abnormality can be identified. Such regions may represent an ischemic zone at risk of infarction.

摘要

目的

研究对急性脑卒中患者进行多层面质子磁共振波谱分析的可行性，并确定该成像技术能否描绘出缺血或梗死的脑区。

方法

对12例大脑中动脉卒中患者在卒中发作后24小时内（平均12小时）进行了多层面质子磁共振波谱分析、磁共振成像和磁共振血管造影。从磁共振图像上显示T2高信号异常的脑区、紧邻这些异常的区域以及对侧解剖结构相似的区域分析波谱。将含有乳酸的脑区与磁共振图像上T2高信号区域进行比较。

结果

由于患者运动产生过多伪影，一个数据集被舍弃。相对于对侧测量值，磁共振图像上T2高信号区域的乳酸含量升高（11例均如此），N - 乙酰天门冬氨酸含量降低（11例中的10例）。紧邻T2高信号区域的乳酸水平与梗死脑区的乳酸水平无显著差异。另一方面，梗死区域的N - 乙酰天门冬氨酸含量明显低于梗死周围组织。含有升高乳酸的脑区面积显著超过T2异常区域。