(1)H MR spectroscopy of inflammation, infection and ischemia of the brain.
Different pathologic patterns in multiple sclerosis (MS) are reflected by alterations of metabolites in (1)H MR spectroscopy of the brain. Elevated choline (Cho), lactate (Lac), lipids and macromolecules are reliable markers for acute demyelination regardless of the clinical entity (also in acute disseminated encephalomyelitis). N-acetyl-aspartate (NAA) is a suitable marker for neuronal integrity. It is reduced in acute MS lesions and in normal appearing white matter, even distant to acute and chronic-lesions. Recovery from reduced NAA levels to subnormal values during remyelination, and varying time courses of NAA in normal appearing white matter during relapsing remitting disease indicate the value of this spectroscopic marker for monitoring activity and recovery. Inositol (Ins) is increased in chronic MS lesions being a marker for astrocytic gliosis. In viral disease, Cho and Ins are always increased, whereas a reduction of NAA mostly reflects an advanced or a detoriated clinical state. In bacterial brain abscesses, numerous amino acids, lipids and Lac can be elevated. In ischemia, especially the Lac/NAA in comparison with perfusion and diffusion weighted imaging seems to be a new measure for areas of metabolic need, and may help to better characterise the penumbra of the stroke and the final infarct size.
Mader
Irina
I
Section of Neuroradiology, Neurocenter of the Freiburg University Hospital, Breisacher Street 64, D-79106 Freiburg, Germany; Freiburg Brain Imaging Center, Department of Neurology of the Freiburg University Hospital, Breisacher Street 64, D-79106 Freiburg, Germany. Electronic address: irina.mader@uniklinik-freiburg.de.
Rauer
Sebastian
S
Department of Neurology of the Freiburg University Hospital, Breisacher Street 64, D-79106 Freiburg, Germany. Electronic address: sebastian.rauer@uniklinik-freiburg.de.
Gall
Peter
P
Department of Radiology, Medical Physics, University Hospital Freiburg, Hugstetter Street 49, 79095 Freiburg, Germany. Electronic address: peter.gall@uniklinik-freiburg.de.
Klose
Uwe
U
Section of Experimental MR of the CNS, Department of Neuroradiology, Radiological University Hospital, Hoppe-Seyler-Street 3, 72076 Tübingen, Germany. Electronic address: uwe.klose@med.uni-tuebingen.de.
D001923:Brain Chemistry; D001927:Brain Diseases / Q000175:diagnosis* / Q000378:metabolism*; D002545:Brain Ischemia / Q000175:diagnosis / Q000378:metabolism; D006801:Humans; D007239:Infections / Q000175:diagnosis / Q000378:metabolism; D007249:Inflammation / Q000175:diagnosis / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*