MR spectroscopy: Predicting long-term neuropsychological outcome following pediatric TBI
MR spectroscopy: Predicting long-term neuropsychological outcome following pediatric TBI
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DOI：
10.1002/jmri.20696
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发表时间：
2006-10-01
影响因子：
4.4
通讯作者：
Holshouser, Barbara A.
中科院分区：
文献类型：
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作者：
Babikian, Talin;Freier, M. Catherin;Holshouser, Barbara A.
目的：为接受创伤性脑损伤 (TBI) 治疗的儿童和青少年确定除临床变量之外的长期神经认知结果的有用急性指标。材料和方法：评估了 20 名儿童/青少年在 TBI 后 6-4 天获得的磁共振波谱 (MRS) 在预测受伤后一到四年的智力和神经心理功能方面的功效。将来自正常大脑的短回波时间单体素 MRS (SVS) 与通过胼胝体 (CC) 水平获取的来自正常大脑和明显损伤大脑的中回波时间多体素 MR 光谱成像 (MRSI) 进行比较。结果：N-乙酰天冬氨酸 (NAA) 与认知评分呈中度至强相关。仅 MRSI 的平均 NAA/肌酸 (Cre) 就可以解释超过 40% 的认知评分差异以及 18% 的高于人口和临床变量的差异。 SVS 代谢物（谷氨酸/谷氨酰胺 [Glx] 和肌醇 [ml]）与认知评分之间存在轻度至中度关联，而胆碱 (Cho) 或 Cre 则没有明显的关联。探索性分析揭示了区域神经影像数据和特定认知能力的趋势。结论：小儿脑损伤患者的急性磁共振波谱可以提高预后能力，并可能为早期治疗和干预计划提供有价值的信息。
Purpose: To identify useful acute indicators of long-term neurocognitive outcome beyond clinical variables for children and adolescents treated for a traumatic brain injury (TBI).Materials and Methods: The efficacy of magnetic resonance spectroscopy (MRS) acquired 6-4 days after TBI in 20 children/ adolescents in predicting intellectual and neuropsychological functioning one to four years post injury was assessed. Short echo-time single voxel MRS (SVS) from normal-appearing brain was compared to intermediate echo-time multivoxel MR spectroscopic imaging (MRSI) from normal-appearing and visibly-injured brain acquired through the level of the corpus callosum (CC).Results: N-acetyl aspartate (NAA) was moderate to strongly correlated with cognitive scores. Mean NAA/creatine (Cre) from MRSI alone explained over 40% of the variance in cognitive scores and 18% of the variance above and beyond demographic and clinical variables alone. Mild to moderate associations were noted between SVS metabolites (glutamate/glutamine [Glx] and myoinositol [ml]) and cognitive scores, with no such associations apparent for choline (Cho) or Cre. Exploratory analyses revealed trends for regional neuroimaging data and specific cognitive abilities.Conclusion: Acute MR spectroscopy of the pediatric brain injury patient improves prognostic ability and may provide valuable information for early treatment and intervention planning.