title: Magnetic resonance spectroscopy study of proton metabolite level changes in sensorimotor cortex after upper limb replantation-revascularization.
abstract: We aimed to investigate the changes in proton metabolite levels at the motor and somatosensory cortex by magnetic resonance spectroscopy (MRS) after upper extremity replantation or revascularization. Nine patients who referred to our clinic suffering from major total (two) and subtotal (seven) amputation of the upper extremity were enrolled in this study. Mean time value between the injury and operation was 5.1 h. Mean follow-up period or mean time between the injury and MRS analysis was 26.2 months (ranging from 7 to 41 months). Voxels (TR: 2000; TE: 136 ms) were placed onto locations in the bilateral precentral and postcentral cortex area of the cerebral hemispheres that represent the upper extremity. Contralateral sides of the brain hemisphere that represent the injured extremity were accounted as control groups. Metabolite ratios [NAA (N-acetyl aspartate)/Cr (creatine) and Cho (choline)/Cr] of the motor and somatosensory cortex were calculated. The NAA/Cr and Cho/Cr metabolite ratios between the two groups were found to be insignificant, and these results may indicate that there is no remarkable somatosensorial cortex disruption or demyelination in these patients. Fifty-six percent of patients were found as functional according to Chen's scale.
authors.affiliation: Department of Orthopaedics and Traumatology, Inonu University, Turgut Ozal Medical Center, 44315 Malatya, Turkey. kertem@inonu.edu.tr
authors.forename: Kadir
authors.initials: K
authors.lastname: Ertem
authors.forename: Alpay
authors.initials: A
authors.lastname: Alkan
authors.forename: Kaya
authors.initials: K
authors.lastname: Sarac
authors.forename: Cagatay
authors.initials: C
authors.lastname: Onal
authors.forename: Haci
authors.initials: H
authors.lastname: Bostan
authors.forename: Saim
authors.initials: S
authors.lastname: Yologlu
authors.forename: Arslan
authors.initials: A
authors.lastname: Bora
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D001923:Brain Chemistry; D002648:Child; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D005260:Female; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011522:Protons; D012092:Replantation; D018709:Statistics, Nonparametric; D034941:Upper Extremity / Q000098:blood supply
chemical_list: D011522:Protons; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline