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@#Introduction: This preliminary study aimed to non-invasively evaluate choline (CHO), creatine (Cr) and intramyocellular lipid (IMCL) metabolites in skeletal muscles at pre- and post-functional electrical stimulation (FES) exercise among incomplete spinal cord injury (SCI) of American Spinal Injury Association Impairment Scale (ASIA-AIS) D patients using proton magnetic resonance spectroscopy or 1 H-MRS. Methods: These metabolites were measured from the vastus lateralis and semitendinosus muscles of three incomplete SCI ASIA-AIS D patients who completed the FES exercise and later underwent 3 Tesla (T) MRI (repetition time/echo time; TR/TE of 3500ms/100ms, field-ofview; FOV of 20cm, slice thickness of 6mm) and 1 H-MRS (TR/TE of 2000ms/31ms, voxel size of 20mm x 20mm x 35mm). Results: Out of those selected metabolites, only CHO value of vastus lateralis showed a statistically significant difference between pre- and post FES exercise 1 H-MRS scanning (p = 0.01). Conclusion: Therefore, this preliminary finding has postulated that the quantification of muscle metabolites using 1 H-MRS imaging could be used as a potential indicator in evaluating the muscle strength for incomplete SCI ASIA-AIS D patients after the completion of FES cycling exercise.
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Objective@#To investigate the value of 1H-magnetic resonance spectroscopy (1H-MRS) in determining the content of liver triglyceride in patients with fatty liver disease (FLD), as well as its influencing factors.@*Methods@#A total of 124 patients with nonalcoholic fatty liver disease (NAFLD), chronic hepatitis B (CHB), or hepatitis B complicated by FLD who underwent liver biopsy in the Affiliated Hospital of Hangzhou Normal University were enrolled, and the clinical data, serological markers, FibroScan results, and 1H-MRS results were collected. A correlation analysis was performed with the results of liver biopsy as the gold standard, and the influence of factors including hepatitic B virus (HBV) infection and obesity on accuracy was analyzed. A one-way analysis of variance was used for comparison of means between the three groups, and the LSD or SNK test (for homogeneity of variance) or the Tamhane’s or Dunnett’s test (heterogeneity of variance) was used for comparison between any two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data. The MRS-PDFF receiver operating characteristic (ROC) curve was plotted, the area under the ROC curve (AUC) was calculated, the optimal cut-off points for the diagnosis of NAFLD were estimated, and sensitivity and specificity were calculated.@*Results@#The NAFLD group (42 patients) and the CHB + NAFLD group (40 patients) had a significantly higher proton density fat fraction (PDFF, the content of triglyceride in the liver) than the CHB group (42 patients) (16.84±9.76/9.39 ± 5.50 vs 3.45 ± 1.63, P < 0.001). The results were significantly correlated with the degree of steatosis confirmed by liver biopsy (P < 0.001), but it was not significantly correlated with inflammation or fibrosis grade. The correlation analysis showed that the MRS-PDFF value measured by 1H-MRS was significantly correlated with body mass index (BMI), blood lipids, alkaline phosphatase, and blood glucose, while it was not significantly correlated with age, sex, or the presence or absence of hepatitis B. The ROC curve analysis showed that the AUCs of PDFF measured by 1H-MRS were 0.93, 0.974, and 0.976, respectively, for the diagnosis of steatosis S1(≥5%), S2(≥34%), and S3(≥66%), and the corresponding optimal thresholds were 5.14%, 11.16%, and 16.7%, respectively.@*Conclusion@#1H-MRS has a high diagnostic value in quantitative evaluation of the degree of liver steatosis in patients with FLD and is not affected by the factors such as HBV infection, age, and sex, while it is correlated with BMI and lipid metabolism.
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Objective To investigate the characteristic changes of the metabolism products in the auditory cortex (transverse temporal gyrus)in patients with metabolic syndrome combined with sensorineural deafness using 1 H magnetic resonance spectroscopy (1 H-MRS),and to find out the early warning indicators of sensorineural deafness in patients with metabolic syndrome.Methods The pure tone audiometry (PTA)was performed in 142 pa-tients with metabolic syndrome (diagnosed by endocrinology department),and 15 healthy subjects as the control group.The patients were divided into four groups:the metabolic syndrome group;the metabolic syndrome group with unilateral,the bilateral deafness group,and the control group.Cerebral metabolism was studied by assessing the ratios of nitro-acetyl aspartate contrast to choline (NAA/Cho)as well as to creatine (NAA/Cr),myo-inosi-tol to creatine (mI/Cr)and choline to creatine (Cho/Cr)ratios in the auditory cortical separately in these groups. ROC curves were made for those metabolism markers to find the best diagnostic threshold.Results Significantly lower values of NAA/Cho ratio and higher values of Cho/Cr were observed in metabolic syndrome in the control group (P<0.05),Cho/Cr higher than those (P<0.05).NAA/Cho ratios in the injured and uninjured auditory cortex of MS with unilateral deafness were significantly lower than those in the control group (P<0.05).A self-comparison was made between the inj ured and uninj ured auditory cortex,the result showed that NAA/Cho ratio had significant differences.All of the metabolisms were tested by the curve of ROC.The area of NAA/Cho under the ROC curve was 81%,which had a higher accuracy.NAA/Cho equating to 1 .82 could be used as the boundary indi-cators between metabolic syndrome without deafness and with deafness groups.The areas of the other indicators un-der the ROC curve were <50%.Conclusion NAA/Cho may be the early warning marker of sensorineural deafness in patients with metabolic syndrome.
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This study aimed to investigate the biochemical profile of blood plasma of patients with coronary artery disease (CAD) and angiographically normal subjects (controls) to determine biomarkers for their differentiation. In this double blind study, 5 mL venous blood was drawn before angiography from CAD patients (n=60) and controls (n=13) comprising angiography normal individuals. In vitro high-resolution NMR spectroscopy of these blood plasma samples was carried out at 400 MHz, and intensity data were analysed with partial least square discriminant analysis. Categorization of subjects as controls or CAD patients and the patients further as single vessel disease (SVD), double vessel disease (DVD) and triple vessel disease (TVD) was done at the end of the study based on their angiography reports. Raised levels of lipids, alanine (Ala) and isoleucine/leucine/valine (Ile/Leu/Val) were observed in CAD patients compared with controls. Partial least square discriminant analysis showed separation between controls vs CAD patients. TVD patients showed increased levels of Ile/Leu/Val and Ala compared with controls and SVD. Alanine, Ile/Leu/Val, and LDL/VLDL appear as possible biomarkers for distinguishing between controls and patients with SVD and TVD. A metabolic adaptation of myocardium may play a role in raising the Ala level.
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Objective To investigate the characteristic changes of the metabolism products in the auditory cortex (transverse temporal gyrus) in diabetes combined with nerve deafness using 1 H magnetic resonance spectros‐copy (1 H -MRS) ,and to discover the early warning indicator of nerve deafness in type 2 diabetes .Methods PTA was performed in 98 patients with type 2 diabetes (diagnosed by Endocrinology Department) ,and in 15 healthy sub‐jects in the control group .The patients were classified into four groups :the group of type 2 diabetes;type 2 diabe‐tes with unilateral and bilateral deafness ,and the normal control group .Cerebral metabolism was studied by assess‐ing the ratios of nitro -acetyl aspartate contrast to choline (NAA/Cho) as well as to creatine (NAA/Cr) ,myo-in‐ositol to creatine (mI/Cr) and choline to creatine (Cho/Cr) ratios in the auditory cortical separately in these groups . The Pearson correlation analysis was applied to determine blood glucose value with the nerve metabolites while the ROC curves were made for those metabolism markers to find the best diagnostic threshold .Results NAA/Cr and NAA/Cho were negatively correlated with AHI index and Cho/Cr ,mI/Cr was positively correlated with blood glu‐cose value .Significantly lower values of NAA/Cho ratio were found in patients'(diabetes without deafness) auditory cortex compared with 15 age-matched control subjects (P<0 .05) .NAA/Cr and NAA/Cho ratio in diabetes with deafness were significantly lower than those in control group (P< 0 .05) ,Cho/Cr higher than those of in other groups (P<0 .05) .NAA/Cr and NAA/Cho ratio in injured and uninjured auditory cortex of diabetes with unilateral deafness were significantly lower than those of in control group (P<0 .05) ,then we made a self -comparison be‐tween the injured and uninjured auditory cortex ,finding that NAA/Cho ratio had a significant difference .All of the metabolisms were tested by the curve of ROC .The area of NAA/Cho under the ROC curve was 81% ,which had a higher accuracy .NAA/Cho equal to 1 .65 can be used as boundary indicators between diabetes without deafness and diabetes with deafness groups ,the areas of the remaining indicators under the ROC curve was<50% .Conclusion NAA/Cho may be the early warning marker of nerve deafness in type 2 diabetes .
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Objective To investigate the characteristic changes of the metabolism products in auditory cortex (transverse temporal gyrus) in patients with OSAHS combined with nerve deafness using 1 H magnetic resonance spectroscopy (1 H - MRS) ,and to discovery the early warning indicator of nerve deafness in OSAHS .Methods PTA was performed in 95 patients with OSAHS (diagnosed by PSG) ,and 15 healthy control subjects ,the patients were classified into four groups :the group of OSAHS ;OSAHS with unilateral and bilateral deafness ,the normal control group .Cerebral metabolism was studied by assessing the ratios of nitro -acetyl aspartate contrast to choline (NAA/Cho) as well as to creatine (NAA/Cr) ,myo -inositol to creatine (mI/Cr) and choline to creatine (Cho/Cr) ratios in the auditory cortical separately in these groups .ROC curves were made for those metabolism markers to find the best diagnositic threshold .Results Significantly lower values of NAA/Cho ratio were found in patients'(OSAHS with deafness) auditory cortex compared with 15 age-matched control subjects (P<0 .05) and OSAHS without deafness (P<0 .05) .Auditory cortical NAA and NAA/Cho ratio in OSAHS with unilateral nerve sensorineual hearing were significantly lower than those of in normal control (P<0 .05) ,but there was no significant difference be-tween the abnormal and ontralateral normal auditory cortex by a self comparison .All of the metabolisms were tested by the curve of ROC .Conclusion Combined with the changes of metabolism ,and the curve of ROC ,NAA/Cho may be the early warning markers of sensorineual hearing was in OSAHS patients .
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Objective To investigate the metabolic changes and the metabolites distribution of different hippocampal regions (head,body and tail)in patients with Alzheimer’s disease (AD)using 1 H-MRS for early diagnosis.Methods The hippocampal multivoxel 1H-MRS at 3.0 T was scanned in 30 patients with AD and other 30 normal cognitive elders (NC)as contrast.The data obtained were processed at a workstation.The hippocampus was divided into 3 parts (head,body and tail),and the ratios of N-acetylaspartate (NAA)/creatine (Cr),myoinositol (MI)/Cr and MI/NAA were calculated respectively.The metabolite ratios and distribution changes were compared between group AD and NC.Results Compared with the group NC,the NAA/Cr in group AD in bilateral hippocampal body and tail was decreased,whereas the MI/Cr and MI/NAA in bilateral body and tail,MI/NAA in left head were opposite (P0.05).Conclusion Metabolic changes and disappearance of the normal distribution in different hippocampal regions detected by 1 H-MRS provide helpful clues for early diagnosis of the AD.
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OBJECTIVE: In the present study, we measured hippocampal N-acetyl-l-aspartate (NAA), choline (CHO) and creatine (CRE) values in patients with panic disorder and healthy control subjects using in vivo 1H MRS. METHODS: We scanned 20 patients meeting Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria for panic disorder and 20 matched healthy controls with a 1.5 Tesla GE Signa Imaging System and measured of NAA, CHO, and CRE in hippocampal regions. RESULTS: When NAA, CHO and CRE values were compared between groups, statistically significant lower levels for all ones were detected for both sides. CONCLUSION: Consequently, in the present study we found that NAA, CHO and CRE values of the patients with panic disorder were lower than those healthy controls. Future studies involving a large number of panic patients may shed further light on the generalizability of the current findings to persons with panic disorder.
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Humans , Aspartic Acid , Choline , Creatine , Light , Panic , Panic DisorderABSTRACT
To evaluate the potential value of 1H Magnetic resonance spectroscopy (MRS) for detecting and characterizing invasive ductal carcinoma of breast. We conducted 1H Magnetic resonance spectroscopy (MRS), using a 3.0T MR scanner, on 40 patients who were histologically diagnosed to have invasive ductal carcinoma (IDC); tumor areas of the patients were designated as experimental samples, and non-tumor areas as control samples. The peak at 3.2 ppm is characteristically intense and observed in 34 cases of the total 40 invasive ductal carcinoma (sensitivity 86.2%; specificity 100%; positive predictive value 100%; negative predictive value 60%). In constrast peak at 1.3 ppm is characteristically intense and observed in normal breast (sensitivity 86.2%; specificity 100%; positive predictive value 100%; negative predictive value 60%). The study shows that 1H MRS can effectively discriminate invasive ductal carcinoma from normal breast in most cases. It also demonstrates the feasibility of localized in vivo 1H MRS technique as a new diagnostic modality in the detection of breast tumor.
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Humans , Breast , Carcinoma, Ductal , Magnetic Resonance Spectroscopy , Magnetics , Magnets , Sensitivity and SpecificityABSTRACT
Aim To observe the neuroprotective effect of platelet activating factor receptor antagonist Kadsurenone on rat brain with cerebral ischemia/reperfusion.Methods Animal model was established through middle cerebral artery occlusion(MCAO).we studied the changes of infarct volume,NAA and Lactate in Kadsurenone-treated group with DWI and()~1H-MRS examination after cerebral ischemia 60 min and reperfusion 1,3,6 h.Results Significant reductions in infarct volume were found in the Kadsurenone-treated group as well as in the Ginkgolides-treated group compared with the control group.And Kadsurenone decreased the concentration of lactate and prevented the decline of the concentration of NAA after cerebral ischemia/reperfusion.Conclusion As platelet-activating factor receptor antagonists,both Kadsurenone and Ginkgolides show remarkable neuroprotective effect.And MRI offers exact neuroimaging information for studying the neuroprotective meachnism of Chinese traditional medicine after cerebral ischemia and reperfusion.
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Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) on hippocampus metabolic changes in rats with temporal lobe epilepsy. Methods A chronic temporal lobe epilepsy model was established by use of lithium-pilocarpine in rats. The hippocampus metabolism of the rats were detected by 1H-MRS method before and after the rTMS and compared with that of the normal controls. Relative ratios of N-acetylaspartate (NAA), choline (Cho), glutamate (Glu) and ?-aminobutyric acid (GABA) over creatine (Cr) were calculated. Results Compared with normal control rats, NAA/Cr and GABA/Cr ratios decreased significantly and Cho/Cr ratios increased significantly in hippocampus of the rats with temporal lobe epilepsy. After rTMS NAA/Cr and GABA/Cr ratios increased significantly and Cho/Cr ratios decreased significantly in hippocampus of rats with temporal lobe epilepsy. However, rTMS did not significantly affect the Glu/Cr ratio in hippocampus of the rats with temporal lobe epilepsy. Conclusion rTMS could improve the hippocampus metabolism and exert a neuroprotective effect against brain damage induced by epilepsy.
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OBJECTIVE: To determine, using proton magnetic resonance spectroscopy (1H MRS) whether thalamotomy in patients with Parkinson's disease gives rise to significant changes in regional brain metabolism. MATERIALS AND METHODS: Fifteen patients each underwent stereotactic thalamotomy for the control of medically refractory parkinsonian tremor. Single-voxel 1H MRS was performed on a 1.5T unit using a STEAM sequence (TR/TM/TE, 2000/14/20 msec), and spectra were obtained from substantia nigra, thalamus and putamen areas, with volumes of interest of 7-8ml, before and after thalamotomy. NAA/Cho, NAA/Cr and Cho/Cr metabolite ratios were calculated from relative peak area measurements, and any changes were recorded and assessed. RESULTS: In the substantia nigra and thalamus, NAA/Cho ratios were generally low. In the substantia nigra of 80% of patients (12/15) who showed clinical improvement, decreased NAA/Cho ratios were observed in selected voxels after thalamic surgery (p < 0.05). In the thalamus of 67% of such patients (10/15), significant decreases were also noted (p < 0.05). CONCLUSION: Our results suggest that the NAA/Cho ratio may be a valuable criterion for the evaluation of Parkinson's disease patients who show clinical improvement following surgery. By highlighting variations in this ratio, 1H MRS may help lead to a better understanding of the pathophysiologic processes occurring in those with Parkinson's disease.
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Adult , Aged , Female , Humans , Male , Aspartic Acid/analogs & derivatives , Brain/metabolism , Choline/metabolism , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Middle Aged , Parkinson Disease/metabolism , Protons , Putamen/metabolism , Substantia Nigra/metabolism , Thalamus/metabolismABSTRACT
Objective To investigate ~1H-MRS findings of brain tumor and the clinical application of ~1H-MRS.Methods 80patients with brain tumors clinically or pathologically-proved underwent ~1H-MRS.Normal opposite hemispheres in 30 cases were used as control group.Single voxel spectroscopy(SVS) or 2D-MRS imaging was performed with excited echo sequence.The mean ratio of metabolisms with difference was compared.Results Compared with control group,NAA of tumor decreased in certain degree(P
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PURPOSE: Thallim-201 (201Tl) brain SPECT and proton (1H) magnetic resonance spectroscopy (MRS) have been used to evaluate tumor grade and viability of glioma. We assessed the correlations between 201Tl brain index or spectrum of metabolites of 1H MRS and grade of glioma or histopathologic findings. MATERIALS AND METHODS: We studied 17 patients (4 astrocytoma, 7 anaplastic astrocytoma and 6 glioblastoma). On 201Tl Brain SPECT, 201Tl index was measured as the ratio of average counts for region of interest to those for the contralateral normal brain. On 1H MRS, we calculated choline (Cho) /creatine (Cr) ratio and N-acetylaspartate (NAA)/Cr ratio in ROI defined as tumor center. Histopathologic findings were graded by Ki-67 index, cellularity, mitosis, pleomorphism, necrosis and endothelial proliferation. An unpaired t test and statistical correlations were performed to evaluate these data. RESULTS: Tl-index showed the best correlation with Ki-67 index (p<0.01), less correlations with cellularity, mitosis, and endothelial proliferation, but no correlation with results of MRS, pleomorphism, or necrosis. The findings of MRS did not correlate with all of the above. The cases of glioblastoma demonstrated a higher Tl-index, Cho/Cr ratio, Ki-67 index and lower NAA/Cr ratio, albeit without statistical significance. CONCLUSION: Even though 201Tl brain SPECT did not correlate directly with grade of malignancy, it may still be useful in determining biological aggressiveness of tumor and prognosis of patients because it correlated well with Ki-67 index, a growth fraction of glioma, cellularity, mitosis and endothelial proliferation.
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Humans , Astrocytoma , Brain , Choline , Glioblastoma , Glioma , Magnetic Resonance Spectroscopy , Mitosis , Necrosis , Pathology , Prognosis , Protons , Tomography, Emission-Computed, Single-PhotonABSTRACT
OBJECTIVE: To investigate the usefulness of 1H-magnetic resonance spectroscopy (1H-MRS) for the early diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE). METHODS: Magnetic resonance image (MRI) and 1H-MRS were performed on fifteen normal volunteers (mean age, 29+/-6 years; age range, 24~40 years) and twenty seven patients with SLE: twelve (26+/-8 years; 16~42 years) with and fifteen (32+/-12 years; 13~57 years) without NPSLE. The localized 1H-MRS was performed by a GE 1.5T SIGNA MRI/MRS system (version 5.5) with active shielded gradients. For all spectra, a Stimulated Echo Acquisition Method (STEAM) localization sequence with three-pulse CHESS H2O suppression was used. The metabolite ratios of N-acetylaspartate (NAA) to creatine (Cr) and choline (Cho) to Cr measured on 1H-MRS of the basal ganglia (BG) and peritrigonal periventricular white matter (PWM). RESULTS: The level of disease activity makers (anti-dsDNA, C3, C4, SLEDAI score), autoantibodies (lupus anticoagulant, anticardiolipin antibody, antiribosomal-P), and EEG did not showed significant difference between the patients without NPSLE and with NPSLE (p>0.05). Thirteen percent (2/15) of patients without NPSLE and fifty percent (6/12) of patient with the NPSLE showed abnormality in MRI. 1H-MRS showed significantly decreased NAA/Cr ratio in BG and increased Cho/Cr ratio in PWM for the patients with NPSLE compared to the patients without NPSLE and normal volunteers (p0.05). But negative correlation was shown between NAA/Cr in BG and Cho/Cr ratio in PWM (r=-0.58, p<0.05). CONCLUSION: NAA/Cr ratio in BG was decreased and Cho/Cr in PWM was increased in NPSLE. The neurometabolite ratio measured by 1H-MRS may be useful in the early detection of NPSLE.
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Humans , Antibodies, Anticardiolipin , Autoantibodies , Basal Ganglia , Choline , Creatine , Early Diagnosis , Electroencephalography , Healthy Volunteers , Lupus Vasculitis, Central Nervous System , Magnetic Resonance Imaging , Spectrum AnalysisABSTRACT
OBJECTIVE: To investigate the usefulness of 1H-magnetic resonance spectroscopy (1H-MRS) for the early diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE). METHODS: Magnetic resonance image (MRI) and 1H-MRS were performed on fifteen normal volunteers (mean age, 29+/-6 years; age range, 24~40 years) and twenty seven patients with SLE: twelve (26+/-8 years; 16~42 years) with and fifteen (32+/-12 years; 13~57 years) without NPSLE. The localized 1H-MRS was performed by a GE 1.5T SIGNA MRI/MRS system (version 5.5) with active shielded gradients. For all spectra, a Stimulated Echo Acquisition Method (STEAM) localization sequence with three-pulse CHESS H2O suppression was used. The metabolite ratios of N-acetylaspartate (NAA) to creatine (Cr) and choline (Cho) to Cr measured on 1H-MRS of the basal ganglia (BG) and peritrigonal periventricular white matter (PWM). RESULTS: The level of disease activity makers (anti-dsDNA, C3, C4, SLEDAI score), autoantibodies (lupus anticoagulant, anticardiolipin antibody, antiribosomal-P), and EEG did not showed significant difference between the patients without NPSLE and with NPSLE (p>0.05). Thirteen percent (2/15) of patients without NPSLE and fifty percent (6/12) of patient with the NPSLE showed abnormality in MRI. 1H-MRS showed significantly decreased NAA/Cr ratio in BG and increased Cho/Cr ratio in PWM for the patients with NPSLE compared to the patients without NPSLE and normal volunteers (p0.05). But negative correlation was shown between NAA/Cr in BG and Cho/Cr ratio in PWM (r=-0.58, p<0.05). CONCLUSION: NAA/Cr ratio in BG was decreased and Cho/Cr in PWM was increased in NPSLE. The neurometabolite ratio measured by 1H-MRS may be useful in the early detection of NPSLE.
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Humans , Antibodies, Anticardiolipin , Autoantibodies , Basal Ganglia , Choline , Creatine , Early Diagnosis , Electroencephalography , Healthy Volunteers , Lupus Vasculitis, Central Nervous System , Magnetic Resonance Imaging , Spectrum AnalysisABSTRACT
Objective:To evaluate magnetic resonance imaging(MRI) and 1 H magnetic resonance spectroscopy( 1HMRS)in the study of normal biochemical process of the brain as well as differentiation of normal senile brain from cerebral diseases related to senility.Methods:180 cases of healthy adults were selected to perform MR examination,in which,none of the subjects had the history of neurological and psychotic diseases according to MRI and clinical results.Meanwhile,60 healthy subjects were selected to perform 1 HMRS examination.The ages ranged from 18 to 80 years.They were divided into six age groups purposely.Point resolved spectroscopy sequence was required for 1 HMRS.The metabolites in the spectra included:N-acetylaspartate(NAA),choline compounds(CHO),creatine compounds(CR),myo-inosito(MI),glutamate and glutamine(Glu-n).Results:(1)In 180 cases of MRI,T 2 relation time was lowest in the deep gray matter in the same age group;T 1relation time was in low-high order,while T 2 relation time was decreased with the increase of age in the different age group.(2)The amplitudes in high-to-low order were as follows in 60 cases of 1 HMRS:NAA、CR、CHO、MI、Glu-n.No prominent difference of shape and peak arrangement was seen at the different ipsilateral site in the same age groups;while slight difference at the same site in the different age groups was present.The ratio of NAA/Cr and Glu-n CR was higher in senile age group;while that of MI/Cr was lower.The ratio of CHO/CR was in low-to high order with the difference of age.The ratio of NAA/CR and MI/CR was gradually lower from anterior to posterior part of the brain;the ratio of CHO/CR was highest in occipital cortex however,no definite changing rule was observed in the ration of Glu-n/CR.Correlation of T 1 relation time and partial metabolite ratio with age was present in gray matter.Conclusion:Quantitative study of MRI and 1 HMRS is essential for determination of normal myelinization and neuronal integrity and age-related biochemical changes in the brain.
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Object of this study was to to evaluate the laterality of local cerebral cellular metabolism in various locations of the brain related to the symptomatic side of patients with clinically diagnosed idiopathic Parkinson's disease (IPD) and to verify GABA-related pathophysiology in IPD by comparing postoperative changes in (GABA+Glutamate)/Cr ratio from patients with IPD after stereotactic pallidotomy and thalamotomy. Fourteen patients with IPD(10 males and 4 females: age range 39-67 years) participated in the study. The patients were classified into two disease subgroups, one for tremor dominant group(n=7, T group), and the other bradykinesia and rigidity dominant one(n=7, B&R group). For T group, stereotactic VL(Vop, Vim) thalamotomy and subthalamotomy was performed and for the B&R group, stereotactic posteroventrolateral pallidotomy was selected. In Vivo 1H MRS study was performed on a 1.5 T MRI/MRS system(GE Sigma Advantage, version 4.8) using STEAM sequence after water suppression with CHESS RF pulse and dephasing gradients. After peak areas of creatine/phosphocreatine(Cr), choline-containning compound(Cho), N-Acetyl Aspartate(NAA), r-aminobutyric acid, (GABA) and glutamate(Glu) were calculated and processed, the metabolic ratios of NAA/Cr, Cho/Cr, and (GABA+Glu)/Cr in three different locations were calculated and compared with clinical symptoms and its changes after surgery. For the neuronal laterality in patients with IPD, there was significant differences of NAA/Cr ratio between the right and left sides of substantia nigra, thalamus and pallidum(p=0.00170). The magnitude of difference in NAA/Cr ratios between right and left side were significantly larger in substantia nigra(p=0.0141). Compared to the normal control values(1.82+/-0.52 in ages 27-50, 1.71+/-0.54 in ages 51-70 years), the neuronal loss was generally observed in at least one of three locationsin all patients. Moreover, NAA/Cr ratio was substantially lower in ipsilateral than contralateral substantia nigra of the parkinsonian symptomatic side. For preoperative(GABA+Glu)/Cr ratios of thalamus contralateral to the symptomatic side compared to that of ipsilateral, it was significant larger in thalamus of B&R group and significant smaller in T group. In the pallidotomy group, there was significant increase in the operated pallidum, whereas significant decrease in (GABA+Glu)/Cr ratios were noted in the operated side thalamus. And in the thalamotomy group, there were significant increase in the operated thalamus, whereas in the operated side pallidum, significant decrease in (GABA+Glu)/Cr ratios were noted. Neuronal laterality, pallidal neuronal loss and postoperative changes in GABA activity in patients with IPD were demonstrated on the basis of NAA/Cr and (GABA+Glu)/Cr ratio by In Vivo 1H MRS. The neuronal laterality was detected in the substantia nigra of all the parkinsonian patient, and NAA/Cr ratios in unilateral and bilateral disease were consistently lower in ipsilateral than in contralateral substantia nigra of the Parkinsonian disease side. Our result suggests that there may be another ongoing pathological process of ipsilateral neuronal degeneration with contralateral dopaminergic neuronal loss. The result of neuronal loss in pallidum supports with the previous reports concerning striatal degeneration in IPD. Our results concerning postoperative changes of (GABA+Glu)/Cr ratio suggests that separate pathophysiologic mechanisms may be involved in the development of two dominant symptom groups of IPD. That is, for the B&R group, pallidal overinhibition to the thalamus by the GABA-ergic system as previously noted, but for T group, a process other than GABA inhibitory mechanism with or without it may be involved.
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Female , Humans , Male , Brain , Dopaminergic Neurons , gamma-Aminobutyric Acid , Hypokinesia , Metabolism , Neurons , Pallidotomy , Parkinson Disease , Steam , Substantia Nigra , Thalamus , Tremor , WaterABSTRACT
To determine the spectral pattern of metabolites in 31 brain tumors in which the presence of lipids, lactate and additional intermediary metabolites had been detected, in vivo 1H-MR spectroscopy was performed. Metastasis (n=3), meningioma(n=7), astrocytic tumors of different grades(n=11), postop recurrent tumors(n=2) and other tumors(n=10) were examined using the stimulated echo(STEAM, TE=30ms) or double spin echo technique(PRESS, TE=272ms) with CHESS pulse for water suppression. The detection of lactate in astrocytic tumors correlated with a higher grade of malignancy, and lipid was observed in most glioblastomas. Elevated lactate levels in tumors do not simply originate in the necrotic region, but are related to the high glycolytic activity of adequately perfused, viable neoplastic cells. Lipid signals were detected in high grade, late stage brain tumors, indicating the need for enhanced phospholipid metabolism and membrane degradation, respectively. The absence of lactate and presence of alanine, glutamate/glutamine in most meningiomas distinguished them from schwannomas and other glial tumors. Observation of the spectral pattern of metabolites in brain tumors in which lipid and lactate has been detected might play an important prognostic role in the management and differentiation of metastasis, glial tumors, tumor recurrence, and other non-neoplastic diseases.
Subject(s)
Alanine , Brain Neoplasms , Brain , Glioblastoma , Lactic Acid , Magnetic Resonance Spectroscopy , Membranes , Meningioma , Metabolism , Neoplasm Metastasis , Neurilemmoma , Protons , Recurrence , Spectrum Analysis , WaterABSTRACT
Background & Significance : Hallervorden-Spatz disease (HSD) is a rare neurologic disorder characterized by progressive dystonia, retinal degeneration, pyramidal sign, and mental deterioration. The neuropathological findings include preferential deposition of iron within the extrapyramidal nuclei, including globus pallidus, substantia nigra, and red nuclei. The final diagnosis depends on the typical pathologic findings. MRI brain imaging study commonly shows so-called "eye-of-the-tiger" in the globus pallidus. However 1H-MRS findings of HSD have not been reported. We experienced a case with clinically suspicious HSD whose diagnosis was further supported by 1H-MRS. Case : A forty four year-old man presented with slowly progressive dystonia for six years. He had been well until age of thirty eight, when he noticed clumsy hand-writing. Three years later, he developed difficulty in chewing. Clumsiness of his hands and arm movements progressed to the point of difficulty in using spoon and chopsticks. While walking, arm swing was decreased and both arms and neck took more dystonic posture. Brain MRI (T2Wl) showed symmetric high signal intensity lesions in the globus pallidus, surrounded by a peripheral zone of exaggerated low signal. On 1H-MRS of basal ganglia, although choline, creatine and N-acetyl-aspartate (NAA) peaks were detected, marked noise probably due to paramagnetic substance (iron), made quantitative analysis difficult. Conclusion : 1H-MRS of HSD is characterized by "noise", which may be suggestive of HSD.