Serial assessments of delayed encephalopathy after carbon monoxide poisoning using magnetic resonance spectroscopy and diffusion tensor imaging on 3.0T system
Serial assessments of delayed encephalopathy after carbon monoxide poisoning using magnetic resonance spectroscopy and diffusion tensor imaging on 3.0T system
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DOI：
10.1159/000109262
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发表时间：
2008-01-01
影响因子：
2.4
通讯作者：
Nakada, Tsutomu
中科院分区：
文献类型：
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作者：
Terajima, Kenshi;Igarashi, Hironaka;Nakada, Tsutomu
为了阐明一氧化碳（CO）中毒后迟发性脑病尚不清楚的机制，我们在3.0T系统上连续进行单体素质子磁共振波谱（H-1-MRS）和扩散张量成像（DTI）并对2名接受高压氧治疗的患者进行智力测试。 H-1-MRS和DTI衍生参数的时间变化表明：（1）即使开始高压氧治疗后，白质脱髓鞘、有氧代谢抑制和细胞毒性水肿仍持续至少3个月； (2)白质的轴突功能和结构完整性最初严重受损，然后在5个月内逐渐部分改善，表现出与智力测试分数类似的变化。结果表明，一氧化碳中毒后的脑损伤可能持续时间比预期长，并且 H-1-MRS 和 DTI 衍生参数是患者临床进展的良好指标。 H-1-MRS与DTI在3.0T系统上的结合有助于监测CO中毒后迟发性脑病患者的脑损伤变化和临床症状。版权所有 (C) 2007 S. Karger AG，巴塞尔。
To elucidate the still unclear mechanism of delayed encephalopathy after carbon monoxide ( CO) poisoning, we serially performed single-voxel proton magnetic resonance spectroscopy (H-1-MRS) and diffusion tensor imaging (DTI) on a 3.0T system and intelligence tests in 2 patients, while they were undergoing hyperbaric oxygenation therapy. The chronological changes in H-1-MRS- and DTI-derived parameters indicated the following: ( 1) White matter demyelination, aerobic metabolism inhibition, and cytotoxic edema persisted for at least 3 months even after starting the hyperbaric oxygenation therapy; ( 2) the axonal function and structural integrity of the white matter were initially severely impaired and then gradually and partially improved for 5 months, showing changes similar to those in the scores of the intelligence tests. The results demonstrated that brain damage after CO poisoning may persist longer than expected, and that the H-1-MRS- and DTI-derived parameters are good indicators of the clinical progress of a patient. The combination of H-1-MRS and DTI on a 3.0T system is useful for monitoring the changes in brain damage and the clinical symptoms of patients with delayed encephalopathy after CO poisoning. Copyright (C) 2007 S. Karger AG, Basel.