Metabolic changes in acute and subacute cerebral infarctions: findings at proton MR spectroscopic imaging.
OBJECTIVE
To analyze the advantages of proton magnetic resonance (MR) spectroscopic imaging in the evaluation of acute and subacute cerebral infarcts.


METHODS
Metabolite maps of choline-containing compounds, total creatine consisting of creatine and phosphocreatine, N-acetyl aspartate (NAA), and lactate were obtained in 23 patients with acute and subacute cerebral infarctions 1-35 days after onset of symptoms. Maps were obtained with a 1.5-T MR system with 32 x 32 phase-encoding steps.


RESULTS
Distinct abnormal metabolite distributions could be detected in all lesions larger than 1 cm in diameter. In the center of infarcts with a diameter larger than the section thickness of 2 cm, NAA values decreased to 20% +/- 8 compared with contralateral brain as early as 1 day after onset of symptoms (P < .0001). Choline was reduced to 67% +/- 30 (not significant) and creatine to 51% +/- 22 (P = .0025). Large amounts of lactate were detected in all acute infarcts. Choline, creatine, and lactate values declined during the first 5 weeks after stroke.


CONCLUSIONS
MR spectroscopic imaging allows visualization of metabolic changes in stroke with a reasonable spatial resolution.
Lanfermann
H
H
Department of Diagnostic Radiology, University of Cologne, Germany.
Kugel
H
H
Heindel
W
W
Herholz
K
K
Heiss
W D
WD
Lackner
K
K
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D002544:Cerebral Infarction / Q000378:metabolism*; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D005260:Female; D006801:Humans; D007773:Lactates / Q000378:metabolism; D019344:Lactic Acid; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D010725:Phosphocreatine / Q000378:metabolism
D007773:Lactates; D010725:Phosphocreatine; D001224:Aspartic Acid; D019344:Lactic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline