Proton magnetic resonance spectroscopy for detection of axonal injury in the splenium of the corpus callosum of brain-injured patients
Proton magnetic resonance spectroscopy for detection of axonal injury in the splenium of the corpus callosum of brain-injured patients
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DOI：
10.3171/jns.1998.88.5.0795
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发表时间：
1998-05-01
影响因子：
4.1
通讯作者：
Lenkinski, RE
中科院分区：
文献类型：
--
作者：
Cecil, KM;Hills, EC;Lenkinski, RE
物体。本研究旨在确定质子磁共振波谱(MRS)是否是检测弥漫性轴索损伤的敏感方法，弥漫性轴索损伤是创伤性脑损伤的主要后遗症。弥漫性轴索损伤的特点是选择性损伤白质束，部分原因是旋转加速和减速产生的严重惯性应变，这通常与机动车事故有关。这种轴突损伤通常很难用传统的成像技术检测出来，因为它本质上是微观的。选择压板是因为它容易受到剪切力的影响，从而产生弥漫性轴索损伤。作者用质子磁共振波谱技术对正常志愿者和脑外伤患者的穹窿进行了评估。质子磁共振波谱通过测量N-乙酰天冬氨酸(NAA)水平提供了神经元和轴突存活的指标。与正常志愿者相比，大多数轻度脑损伤患者以及严重损伤患者的压部NAA/肌酸(Cr)水平降低。压部NAA/Cr值降低的患者也可能出现叶白质NAA/Cr值降低。还有。正常志愿者脑白质中NAA/Cr值明显高于脑叶白质。压部NAA/Cr值的降低可能是弥漫性损伤的一个标志。质子磁共振波谱检查在评估有不明原因的神经和认知缺陷的轻度损伤患者时可能特别有用。结论：MRS是诊断轴索损伤的敏感手段。
Object. This study was conducted to determine whether proton magnetic resonance spectroscopy (MRS) is a sensitive method for detecting diffuse axonal injury, which is a primary sequela of traumatic brain injury (TBI). Diffuse axonal injury is characterized by selective damage to white matter tracts that is caused in part by the severe inertial strain created by rotational acceleration and deceleration, which is often associated with motor vehicle accidents. This axonal injury is typically difficult to detect by using conventional imaging techniques because it is microscopic in nature. The splenium was selected because it is a site vulnerable to shearing forces that product diffuse axonal injury.Methods. The authors used proton MRS to evaluate the splenium, the posterior commissure of the corpus callosum, in normal control volunteers and in patients with TBI. Proton MRS provided an index of neuronal and axonal viability by measuring levels of N-acetyl aspartate (NAA).Conclusions. A majority of mildly brain injured patients, as well as those more severely injured, showed diminished NAA/creatine (Cr) levels in the splenium compared with normal control volunteers. The patients displaying lowered NAA/Cr in the splenium were also likely to exhibit lowered NAA/Cr in lobar white matter. Also. the levels of NAA/Cr in the splenium of normal volunteers were higher compared with those found in lobar white matter. Decreases in NAA/Cr levels in the splenium may be a marker for diffuse injury. A proton MRS examination may be particularly useful in evaluating mildly injured patients with unexplained neurological and cognitive deficits. It is concluded that MRS is a sensitive tool in detecting axonal injury.