title: Multivoxel proton magnetic resonance spectroscopy in heat stroke.
abstract: OBJECTIVE
  To assess the role of proton MR spectroscopy (MRS) in the detection of changes in metabolite levels of the cerebellum after heat stroke (HS).
  
  
  METHODS
  The study group consisted of eight patients after HS, with a Glasgow Coma Scale (GCS) score of 3-9. The MR studies were performed with a 1.5 T system. MR spectra were recorded from a normal-appearing cerebellum region. Spectra from patients were compared with a control group including seven age-matched healthy volunteers recorded with the same techniques. Metabolites ratios including N-acetyl aspartate/creatine (NAA/Cr), N-acetyl aspartate/creatine2 (NAA/Cr2), choline/creatine (Cho/Cr), choline/creatine2 (Cho/Cr2), and N-acetyl aspartate/choline (NAA/Cho) were calculated and the differences between the two groups were evaluated using the Mann-Whitney U-test. Pearson correlation analysis was used to analyse the relationship between NAA/Cr ratios and GCS scores for eight patients after HS.
  
  
  RESULTS
  In the cerebellum of the patients after HS, NAA/Cr ratios were found to be significantly decreased compared to normal controls (p = 0.004) and Cho/Cr ratios were found to be decreased compared to normal controls (p = 0.032). Significant positive correlation was found between NAA/Cr ratios and GCS scores for eight patients after HS (r = 0.748, p = 0.033).
  
  
  CONCLUSIONS
  Metabolite abnormalities were seen in normal-appearing cerebellum structures in patients after HS. Proton MRS is a useful tool for evaluating major changes in metabolite levels of the cerebellum after HS and the severity of the disease can be effectively evaluated by NAA/Cr ratios.
authors.affiliation: Shandong Medical Imaging Research Institute, Shandong University, No. 324, Jingwu Road, Jinan, 250021, Shandong, China; Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, No. 717, Jinbu Street, Yantai, 264100, Shandong, China.
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.affiliation: Binzhou Medical University, No. 346, Guanhai Road, Yantai, 264003, Shandong, China.
authors.forename: X Y
authors.initials: XY
authors.lastname: Zhang
authors.affiliation: Binzhou Medical University, No. 346, Guanhai Road, Yantai, 264003, Shandong, China. Electronic address: binwang001@aliyun.com.
authors.forename: B
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, No. 717, Jinbu Street, Yantai, 264100, Shandong, China.
authors.forename: Z M
authors.initials: ZM
authors.lastname: Zou
authors.affiliation: Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, No. 717, Jinbu Street, Yantai, 264100, Shandong, China.
authors.forename: H F
authors.initials: HF
authors.lastname: Li
authors.affiliation: Binzhou Medical University, No. 346, Guanhai Road, Yantai, 264003, Shandong, China.
authors.forename: P Y
authors.initials: PY
authors.lastname: Wang
authors.affiliation: Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, No. 717, Jinbu Street, Yantai, 264100, Shandong, China.
authors.forename: J K
authors.initials: JK
authors.lastname: Xia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D002531:Cerebellum / Q000378:metabolism*; D002794:Choline / Q000032:analysis*; D003401:Creatine / Q000032:analysis*; D005260:Female; D015600:Glasgow Coma Scale; D018883:Heat Stroke / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D066244:Proton Magnetic Resonance Spectroscopy / Q000379:methods*
chemical_list: D015415:Biomarkers; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline