Cerebral metabolites in patients with acute and subacute strokes: concentrations determined by quantitative proton MR spectroscopy.
OBJECTIVE
The purpose of this study was to determine the feasibility of measuring concentrations of cerebral metabolites in acute and subacute stroke patients using single-voxel localized proton MR spectroscopy and to compare these concentrations to those in contralateral brain regions and in normal healthy volunteers.


METHODS
Single-voxel proton MR spectroscopy and MR imaging were performed in 14 stroke patients, at times ranging from 2 hr to 10 days following the onset of symptoms. Signals from choline, creatine, N-acetyl-L-aspartate (NAA), and lactate were quantified in the infarcted region (n = 14) and in the hemisphere contralateral to the stroke (n = 8) and compared with data obtained from a group of 10 control subjects.


RESULTS
Infarcts were characterized by significantly increased lactate (12 of 14 patients; 7.5 +/- 8.9 mumol/g wet weight, mean +/- SD) and significantly decreased NAA (12 of 14 patients; 5.5 +/- 3.2 mumol/g wet weight), compared with contralateral brain regions and control data in healthy volunteers. Significant reductions in choline, creatine, and NAA were also found in contralateral brain regions compared with the control patients.


CONCLUSIONS
Quantitative single-voxel proton spectroscopy is feasible for use in clinical studies of acute stroke. Ratio measurements or comparison with contralateral metabolites may be misleading because all metabolites may change during infarction, and contralateral metabolite levels may also be different from normal subjects.
Mathews
V P
VP
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Barker
P B
PB
Blackband
S J
SJ
Chatham
J C
JC
Bryan
R N
RN
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000032:analysis; D001921:Brain / Q000378:metabolism*; D002561:Cerebrovascular Disorders / Q000378:metabolism*; D002648:Child; D002794:Choline / Q000032:analysis*; D003401:Creatine / Q000032:analysis*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007773:Lactates / Q000032:analysis*; D019344:Lactic Acid; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged
D007773:Lactates; D001224:Aspartic Acid; D019344:Lactic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline