J Korean Soc Magn Reson Med.
1999 Jun;3(2):146-153.
MR Spectroscopic Patterns of Early and Late Cerebral Ischemic Infarct: Correlation with Clinical Findings
- Affiliations
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- 1Department of Radiology and Institute of Radiation Medicine, Seoul National University, College of Medicine.
- 2Department of Neurology, Seoul National University, College of Medicine.
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.
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