1H MRS in acute traumatic brain injury

被引：151

作者：

Ross, BD ^{[1
]}

Ernst, T ^{[1
]}

Kreis, R ^{[1
]}

Haseler, LJ ^{[1
]}

Bayer, S ^{[1
]}

Danielsen, E ^{[1
]}

Blüml, S ^{[1
]}

Shonk, T ^{[1
]}

Mandigo, JC ^{[1
]}

Caton, W ^{[1
]}

Clark, C ^{[1
]}

Jensen, SW ^{[1
]}

Lehman, NL ^{[1
]}

Arcinue, E ^{[1
]}

Pudenz, R ^{[1
]}

Shelden, CH ^{[1
]}

机构：

[1] Huntington Med Res Inst, Pasadena, CA 91105 USA

来源：

JOURNAL OF MAGNETIC RESONANCE IMAGING | 1998年 / 8卷 / 04期

关键词：

MR spectroscopy; blunt head trauma; diffuse axonal injury; N-acetylaspartate; lactate; prognosis;

D O I：

10.1002/jmri.1880080412

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

The objective of this study was to demonstrate H-1 MR spectroscopy (MRS) changes in cerebral metabolites after acute head trauma, Twenty-five patients (12 children, 13 adults) were examined with quantitative H-1 MRS after closed head injury. Clinical grade (Glasgow Coma Scale [GCS]) and outcome (Rancho Los Amigos Medical Center Outcome Score [ROS]) were correlated with quantitative neurochemical findings. N-acetylaspartate (NAA), a neuronal and axonal marker, was reduced (P <.03-.001). In children, a reduced NAA/creatine plus phosphocreatine (Cr) level and the presence of detectable lipid/lactate predicted bad outcome (sensitivity, 89%; specificity, 89%). The first MRS examination of all patients correlated with ROS versus NAA (r =.65, P <.0001). Although most patients showed MRS abnormalities, striking heterogeneity of H-1 MRS characterized the individual patients. IH MRS identifies multiple patterns of diffuse brain injury after blunt head trauma. There was a strong correlation between MRS and outcome. Future prospective studies will be needed to determine the clinical usefulness of MRS in predicting outcome from closed head injury.

引用

页码：829 / 840

页数：12

共 23 条

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