title: Acute stroke: evaluation with serial proton MR spectroscopic imaging.
abstract: OBJECTIVE
  To investigate the evolution of metabolic changes detectable with proton magnetic resonance (MR) spectroscopic imaging in acute stroke and to compare these findings with those of conventional MR imaging.
  
  
  METHODS
  A patient with middle cerebral artery stroke underwent conventional proton-density (PD)- and T2-weighted MR imaging, MR angiography, and multisection proton two-dimensional MR spectroscopic imaging over a period of 3 hours to 5 months after symptom onset.
  
  
  RESULTS
  On 3-hour MR images, no abnormal signal intensity change was detectable. Spectroscopic images obtained at 24 hours showed localized elevation of cerebral lactate levels. In most regions with high lactate levels, infarction subsequently occurred. In the chronic stage (5 months), the infarct was associated with reduced N-acetylaspartate levels, increased choline levels, and absence of lactate.
  
  
  CONCLUSIONS
  Spectroscopic imaging enables mapping of ischemic and infarcted brain regions with greater sensitivity than does conventional MR imaging.
authors.affiliation: Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD 21205.
authors.forename: P B
authors.initials: PB
authors.lastname: Barker
authors.forename: J H
authors.initials: JH
authors.lastname: Gillard
authors.forename: P C
authors.initials: PC
authors.lastname: van Zijl
authors.forename: B J
authors.initials: BJ
authors.lastname: Soher
authors.forename: D F
authors.initials: DF
authors.lastname: Hanley
authors.forename: A M
authors.initials: AM
authors.lastname: Agildere
authors.forename: S M
authors.initials: SM
authors.lastname: Oppenheimer
authors.forename: R N
authors.initials: RN
authors.lastname: Bryan
mesh_terms: D000208:Acute Disease; D001921:Brain / Q000473:pathology; D001923:Brain Chemistry; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D007773:Lactates / Q000032:analysis; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged
chemical_list: D007773:Lactates