MR Spectroscopic Patterns of Early and Late Cerebral Ischemic Infarct: Correlation with Clinical Findings.
- Author:
Jong Seok LEE
1
;
Kee Hyun CHANG
;
In Chan SONG
;
Young Hwan KOH
;
Dong Wha KANG
;
Moon Hee HAN
;
Jae Kyu ROH
Author Information
1. Department of Radiology and Institute of Radiation Medicine, Seoul National University, College of Medicine.
- Publication Type:Original Article
- MeSH:
Brain;
Follow-Up Studies;
Humans;
Magnetic Resonance Spectroscopy;
Male;
Protons;
Reference Values;
Stroke
- From:Journal of the Korean Society of Magnetic Resonance in Medicine
1999;3(2):146-153
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To evaluate the proton MR spectroscopy (MRS) findings of early and late ischemic infarcts and to compare these MRS findings with clinical symptoms. MATERIALS AND METHODS: We obtained MRS spectra of 28 consecutive patients with early ischemic infarct (15 men, 13 women) between 2-10 (mean 6.2) days after stroke onset. Follow-up MRS was carried out between 20-32 (mean 25) days in 12 patients. The MRS spectra were acquired at 1.5 T MR unit using single voxel technique with PRESS sequence, TR of 2000ms, TE of 288 (144)ms, and voxel size of 2cm x 2cm x 2cm in the three areas; an infarct lesion, the brain parenchyma adjacent to the lesion, and contralateral normal brain parenchyma. The NAA/creatine, choline/creatine, and lactate/creatine ratios were calculated in each spectrum. The spectra of MRS were compared with clinical symptoms. RESULTS: In early infarct, decreased NAA/creatine ratio (n=22) and increased lactate/creatine ratio (n=25) were found in the infarct lesion. Choline/creatine ratio was within normal range (n= 25). On follow-up MRS in late stage, NAA/creatine ratio in the infarct lesion decreased further (n= 5), did not change (n= 6), or increased (n= 1). Lactate/creatine ratio became less elevated (n= 10), or did not changed (n= 2). Choline/creatine ratio had a trend for increase. The decreased NAA/creatine and increased lactate/creatine ratios were correlated well with the severity of symptoms, respectively. CONCLUSION: Decreased NAA/creatine and increased lactate/creatine ratios were common MRS findings characteristic in early ischemic infarct and correlated well with clinical severity. On follow-up MRS in late stage, NAA/creatine ratio decreased further or did not change, and lactate/creatine ratio became less elevated.
