Effects of edema metabolic and hematoma dynamics changes on motor and cognitive recovery in intracerebral hemorrhage patients based on MR spectroscopy imaging
10.3969/j.issn.1002-1671.2025.05.001
- VernacularTitle:基于MR波谱成像的脑出血水肿区代谢与血肿动态变化对患者运动及认知康复的影响
- Author:
Yajie CHEN
1
;
Rongrong ZHANG
;
Feng CHEN
;
Xiang CHEN
;
Yang LI
;
Yuhao XU
;
Yan ZHU
;
Ranchao WANG
Author Information
1. 扬州大学附属医院影像科,江苏 扬州 225009
- Publication Type:Journal Article
- Keywords:
intracerebral hemorrhage;
magnetic resonance spectroscopy;
edema metabolism;
hematoma changes;
motor and cogni-tive recovery
- From:
Journal of Practical Radiology
2025;41(5):721-725
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of edema metabolic and hematoma dynamics changes on motor and cog-nitive recovery outcomes in patients with intracerebral hemorrhage(ICH).Methods The CT data of ICH patients were collected to evaluate hematoma volume changes from admission to day 3.On day 3,multivoxel magnetic resonance spectroscopy(MRS)was per-formed with region of interest located in the edema region and contralateral normal tissue.Motor and cognitive function recovery was assessed using the simplified F-M scale and the Montreal cognitive assessment(MoCA)on day 3 and at the 3-month follow-up,respec-tively.Overall clinical outcomes were assessed using the Glasgow outcome scale(GOS),and all patients were divided into good and poor outcome groups.Clinical data and metabolic differences in the edema region between the two groups were compared,respec-tively.Logistic regression analysis and receiver operating characteristic(ROC)curves were used to identify and evaluate independent prognostic factors.Subgroup analysis were performed via stratification of hematoma location.Results The logistic regression analy-sis indicated that intraventricular extension,hematoma changes,and the ratio of N-acetyl aspartate(NAA)around the hematoma to contralateral normal brain parenchyma NAA(rNAA)were inde-pendent prognostic factors for poor outcomes(P＜0.05).The area under the curve(AUC)for each factor and the combined model were 0.69,0.73,0.79,and 0.82,respectively.In patients with ICH in the basal ganglia region,△F-M was negatively correlated with hematoma changes and positively correlated with rNAA value(P＜0.001).In patients with ICH in the thalamic and lobar regions,△MoCA was not significantly correlated with hematoma changes(P＞0.05),but was positively correlated with rNAA value(P＜0.001).Conclusion The rNAA holds predictive value for motor and cognitive recovery outcomes following standard treatment.
