title: Metabolic changes in acute and subacute cerebral infarctions: findings at proton MR spectroscopic imaging.
abstract: 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.
authors.affiliation: Department of Diagnostic Radiology, University of Cologne, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Lanfermann
authors.forename: H
authors.initials: H
authors.lastname: Kugel
authors.forename: W
authors.initials: W
authors.lastname: Heindel
authors.forename: K
authors.initials: K
authors.lastname: Herholz
authors.forename: W D
authors.initials: WD
authors.lastname: Heiss
authors.forename: K
authors.initials: K
authors.lastname: Lackner
mesh_terms: 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
chemical_list: D007773:Lactates; D010725:Phosphocreatine; D001224:Aspartic Acid; D019344:Lactic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline