PROTON MAGNETIC-RESONANCE SPECTROSCOPY OF CEREBRAL LACTATE AND OTHER METABOLITES IN STROKE PATIENTS
PROTON MAGNETIC-RESONANCE SPECTROSCOPY OF CEREBRAL LACTATE AND OTHER METABOLITES IN STROKE PATIENTS
复制标题
DOI：
10.1161/01.str.23.3.333
复制
发表时间：
1992-03-01
期刊：
影响因子：
8.3
通讯作者：
PRICHARD, JW
中科院分区：
文献类型：
--
作者：
GRAHAM, GD;BLAMIRE, AM;PRICHARD, JW
背景和目的：质子磁共振波谱可以无创地测量活体脑内乳酸等代谢物。我们测定了16例皮质或深部脑梗塞患者发病后3周内的生化变化，并对其中6例进行了随访研究。方法：采用2.1T全身磁铁，采用模拟回波脉冲序列，回声时间为270毫秒，对脑梗死区进行一维质子光谱成像。结果：除1例外，所有皮质卒中患者梗死灶内或梗死区附近乳酸均升高。在连续研究的6个病例中，有5个病例的脑乳酸持续升高，持续时间长达251天。N-乙酰天冬氨酸水平在大多数皮质卒中中降低。4例患者中有2例在皮质下小梗死后的第一周出现乳酸升高，并伴有N-乙酰天冬氨酸的轻微下降。这种乳酸可能来自持续的缺血或渗入的白细胞，也可能是最初损伤时形成的乳酸的残留物。在病变发生后的任何时间观察中风后升高的乳酸池的能力提供了一种在未来区分这些可能性的方法。
Background and Purpose: Proton magnetic resonance spectroscopy can measure in vivo brain lactate and other metabolites noninvasively. We measured the biochemical changes accompanying stroke in 16 human subjects with cortical or deep cerebral infarcts within the first 3 weeks after symptom onset, and performed follow-up studies on six.Methods: One-dimensional proton spectroscopic imaging encompassing the infarct region was performed with a 2.1-T whole-body magnet using the stimulated echo pulse sequence and an echo time of 270 msec.Results: All but one of the cortical stroke patients had increased lactate within or near the infarct. Persistently elevated cerebral lactate was documented in five of six cases studied serially as long as 251 days after infarction. N-acetylaspartate levels were decreased in most cortical strokes. Elevated lactate, accompanied by minimal reduction in N-acetylaspartate, was recorded in two of four patients in the first week following a small subcortical infarct.Conclusions: Long-term elevation of lactate commonly occurs after stroke. This lactate may arise from ongoing ischemia or infiltrating leukocytes, or it may be a residual of the lactate formed during the initial insult. The ability to observe stroke-elevated lactate pools at any time after lesion onset provides an approach to distinguishing among these possibilities in the future.