Proton magnetic resonance spectroscopic imaging in the clinical evaluation of patients with Niemann-Pick type C disease.
OBJECTIVE
10 patients with Niemann-Pick disease type C (NP-C) were studied by proton magnetic resonance spectroscopic imaging (1H-MRSI) to assess the biochemical pathology of the brain and to determine whether this method can be useful to clinically evaluate these patients.


METHODS
1H-MRSI permits the simultaneous measurement of N-acetyl aspartate (NA), compounds containing choline (Cho), creatine plus phosphocreatine (Cre), and lactate (Lac) signal intensities from four 15 mm slices divided into 0.84 ml single volume elements. Spectroscopic voxels were identified from seven regions of interest.


RESULTS
In patients with NP-C, NA/Cre was significantly decreased in the frontal and parietal cortices, centrum semiovale, and caudate nucleus; Cho/Cre was significantly increased in the frontal cortex and centrum semiovale. Significant correlations were found between clinical staging scale scores and 1H-MRSI abnormalities.


CONCLUSIONS
1H-MRSI showed diffuse brain involvement in patients with NP-C consistent with the pathological features of the disease. 1H-MRSI is an objective and sensitive tool to neurologically evaluate patients with NP-C.
Neuroimaging Branch, National Institutes of Health, Bethesda, MD, USA.
G
G
Tedeschi
S
S
Bonavita
N W
NW
Barton
A
A
Betolino
J A
JA
Frank
N J
NJ
Patronas
J R
JR
Alger
R
R
Schiffmann
D000293:Adolescent; D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001921:Brain / Q000473:pathology*; D002421:Caudate Nucleus / Q000473:pathology; D002648:Child; D002794:Choline / Q000378:metabolism*; D003401:Creatine / Q000378:metabolism*; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D019344:Lactic Acid / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009542:Niemann-Pick Diseases / Q000145:classification / Q000175:diagnosis*; D010296:Parietal Lobe / Q000473:pathology; D010725:Phosphocreatine / Q000378:metabolism*
D010725:Phosphocreatine; D001224:Aspartic Acid; D019344:Lactic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline