Proton magnetic resonance spectroscopy of human brain: Applications to normal white matter, chronic infarction, and MRI white matter signal hyperintensities

Sappey-Marinier, Dominique; Calabrese, Giovanna; Hetherington, Hoby P.; Fisher, S. N. G.; Deicken, Raymond F.; Dyke, Craig Van; Fein, George; Weiner, Michael W.

doi:10.1002/mrm.1910260211

Cited by 120 publications

(74 citation statements)

References 42 publications

(18 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 However, other studies found either an increase 5,6 or a decrease in choline levels 7,8 in stroke lesions. Discrepancies might be related to individual variability, the small sample sizes of 10 patients or less in some studies, 5,7 or to the use of different patients scanned at different time points rather than the same patients scanned at similar times. 8 The current study is the largest to date following the same group of patients with stroke longitudinally using proton MR spectroscopic imaging at fixed time points to reduce this variability.…”

Section: Discussionmentioning

confidence: 95%

Choline and Creatine Are Not Reliable Denominators for Calculating Metabolite Ratios in Acute Ischemic Stroke

Maniega

Cvoro

Armitage

et al. 2008

Stroke

View full text Add to dashboard Cite

Background and Purpose-Choline and creatine are commonly used as denominators for other metabolites in ischemic stroke spectroscopy, assuming that they do not change. We investigated their concentration variation over time after stroke. Methods-Choline and creatine concentrations were measured by proton MR spectroscopic imaging in 51 patients at 5 times up to 3 months after stroke. Results-Choline and creatine levels changed significantly in the ischemic region. Choline was significantly reduced during the first 2 weeks after stroke onset (Pϭ0.034). Creatine was significantly reduced during the whole period of the study (Pϭ0.011). Conclusion-Choline and creatine concentrations are not reliable denominators for metabolite ratios in acute stroke because their levels vary significantly in ischemic brain regions.

show abstract

Section: Discussionmentioning

confidence: 95%

Choline and Creatine Are Not Reliable Denominators for Calculating Metabolite Ratios in Acute Ischemic Stroke

Maniega

Cvoro

Armitage

et al. 2008

Stroke

View full text Add to dashboard Cite

show abstract

“…However, as we have discussed before, a large part of the lactate signal overlapped with lipid signals in conventional MRS measurements (Kimura et al, 2001;Shimizu et al, 1996). Thus, lactate has been thought to rise early after the insult in the acute phase (<24 h) and may remain high over a long period into the chronic phase (>7 days) (Sappey-Marinier et al, 1992), which could lead us to an inappropriate understanding of the pathophysiological status in the ischemic lesion. In the present study, we could measure isolated lactate signals in the ischemic lesion, demonstrating that they rapidly rise after stroke but disappear within several days.…”

Section: Discussionmentioning

confidence: 99%

“…Proton MR spectroscopy is a noninvasive method that allows measurement of various metabolites in vivo, such as choline-containing compounds (Cho), creatine and creatine phosphate (Cr), N-acetyl aspartate (NAA), and pathologic levels of lactate (Bottomleym, 1987;Frahm et al, 1989;Sappey-Marinier et al, 1992). Detection of lactate by in vivo proton magnetic resonance spectroscopy may provide a means of identifying regions of metabolic stress in brain and other human tissue, potentially identifying regional ischemia in stroke (Federico et al, 1994;Saunders, 2000;Schwarcz et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance lactate and lipid signals in rat brain after middle cerebral artery occlusion model

Harada

Honmou

et al. 2007

Brain Research

View full text Add to dashboard Cite

Proton magnetic resonance spectroscopy (1-H MRS) has revealed changes of metabolites in acute cerebral infarction. Although the drastic changes of lactate and N-acetyl-aspartate have been reported to be useful indicators of the ischemic damage in both humans and experimental animals, lipid signals are also detected by the short echo time sequence 1-5 days after ischemia. The objective of this study was to find a novel technique to isolate lactate signals from lipid signals in the ischemic brain. First, MRS was used to study the lipid and lactate components of a spherical phantom in vitro, and parameters were established to separate these components in vitro. Then, MR measurements were obtained from the brains of middle cerebral artery occlusion rats. All MR measurements were performed using a 7-T (300 MHz), 18.3-cm-bore superconducting magnet (Oxford Magnet Technologies) interfaced to a Unity INOVA Imaging System (Varian Technologies). T 2 -weighted images were obtained from a 1.0-mm-thick coronal section using a 3-cm field of view. It is well known that lipid has a shorter and lactate a longer T 2 relaxation time. These distinct magnetic characteristics allowed us to separate the lactate signal from the lipid signal. Thus, adjustment of the echo time is essential to analyze the metabolites in acute cerebral infarction, which may be useful in both the clinic and laboratory.

show abstract

“…Key Words: nuclear magnetic resonance Ⅲ lipids Ⅲ lactic acid Ⅲ cerebral infarction Ⅲ cerebrovascular accident I n vivo proton magnetic resonance spectroscopy (MRS) has consistently detected elevated brain lactate after human stroke that may persist for many months. [1][2][3][4][5] The origin and significance of this lactate may vary at different times during the evolution of the infarct. While lactate is produced acutely by ischemia, lactate seen beyond the first 72 hours may reflect the presence of macrophages and other leukocytes.…”

mentioning

confidence: 99%

“…[1][2][3][4][5] The origin and significance of this lactate may vary at different times during the evolution of the infarct. While lactate is produced acutely by ischemia, lactate seen beyond the first 72 hours may reflect the presence of macrophages and other leukocytes.…”

mentioning

confidence: 99%

Spectroscopic Assessment of Alterations in Macromolecule and Small-Molecule Metabolites in Human Brain After Stroke

Graham

Hwang

Rothman

et al. 2001

Stroke

View full text Add to dashboard Cite

Background and Purpose-We sought to measure the temporal evolution and spatial distribution of lesion macromolecules and small molecules (lactate, N-acetyl compounds, creatine, and choline) in stroke patients by using short echo time in vivo proton MR spectroscopy. Methods-Single-voxel spectra with TEϭ22 ms were obtained with and without inversion recovery suppression of small-molecule resonances from 30 examinations of 24 patients 3 to 214 days after stroke. Subtraction of the suppressed from the unsuppressed spectra yielded metabolite spectra without overlap from macromolecules. Two-dimensional spectroscopic images were acquired with macromolecule and small-molecule suppression from 5 additional patients. Results-Macromolecule signals were elevated in lesions relative to normal brain and tended to increase in the subacute period, even as lactate peaks declined. Regions of increased lactate, increased macromolecule signal at 1.3 ppm, and decreased N-acetyl compounds were closely correlated in the 2D spectroscopic images. Key Words: nuclear magnetic resonance Ⅲ lipids Ⅲ lactic acid Ⅲ cerebral infarction Ⅲ cerebrovascular accident I n vivo proton magnetic resonance spectroscopy (MRS) has consistently detected elevated brain lactate after human stroke that may persist for many months. [1][2][3][4][5] The origin and significance of this lactate may vary at different times during the evolution of the infarct. While lactate is produced acutely by ischemia, lactate seen beyond the first 72 hours may reflect the presence of macrophages and other leukocytes. 6,7 Previous studies 2,8 used long echo times (TEs) of 270 ms to optimize lactate and eliminate coresonant lipid signals. However, the use of long TEs has several drawbacks. Signal magnitudes for all peaks are decreased due to T2 relaxation during the long echo interval, and signals from rapidly relaxing compounds, such as lipids and proteins within injured tissue, may disappear entirely. Conclusions-ShortRecently introduced short TE methods can measure both small-molecule peaks from lactate, N-acetyl compounds (NA), creatine, and choline, and macromolecule signals in vivo. 9 We have applied these methods to record changes in the small-molecule and macromolecule spectrum after stroke using single volume techniques. We have also used a 2-dimensional spectroscopic imaging (2D-SI) implementation of these methods to assess the spatial extent and coincidence of the biochemical changes. Subjects and Methods PatientsThis study was reviewed and approved by the Human Investigation Committee of the Yale University School of Medicine. Informed consent was obtained from all subjects before MR examination. A total of 33 single-voxel studies were performed on patients with cortical or deep white matter ischemic strokes identified on a scout image, from which 30 usable spectra were obtained. Twenty-one subjects (11 men and 10 women; average age 64 years, range 38 to 87 years) underwent MRS within 10 days of presentation, and 6 follow-up examinations on days 11,19, 32, 34, 67, and ...

show abstract

Proton magnetic resonance spectroscopy of human brain: Applications to normal white matter, chronic infarction, and MRI white matter signal hyperintensities

Cited by 120 publications

References 42 publications

Choline and Creatine Are Not Reliable Denominators for Calculating Metabolite Ratios in Acute Ischemic Stroke

Choline and Creatine Are Not Reliable Denominators for Calculating Metabolite Ratios in Acute Ischemic Stroke

Magnetic resonance lactate and lipid signals in rat brain after middle cerebral artery occlusion model

Spectroscopic Assessment of Alterations in Macromolecule and Small-Molecule Metabolites in Human Brain After Stroke

Contact Info

Product

Resources

About