Longitudinal MR Spectroscopy Shows Altered Metabolism in Traumatic Brain Injury.
Longitudinal MR Spectroscopy Shows Altered Metabolism in Traumatic Brain Injury.
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DOI：
10.1111/jon.12463
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发表时间：
2017-11
期刊：
影响因子：
--
通讯作者：
Sheriff S
中科院分区：
文献类型：
--
作者：
Maudsley AA;Govind V;Saigal G;Gold SG;Harris L;Sheriff S
众所周知，脑外伤会导致组织损伤的异质性模式以及随着时间的推移而发生的神经元和神经胶质代谢的改变；然而，人们对这些变化的纵向演变知之甚少。在这项研究中，磁共振波谱成像（MRSI）用于绘制单个受试者在损伤后28个月的五个时间点上代谢改变的分布。在受伤后7周到28个月的五个时间点，对经历中度创伤性脑损伤（格拉斯哥昏迷量表13）的受试者进行MRI和体积MRSI数据采集。生成n -乙酰天冬氨酸（NAA）、总胆碱（Cho）和总肌酸信号图，并使用z-score图像分析方法识别与正常对照值的差异。z-score代谢物图谱显示，在整个研究过程中，NAA显著减少，Cho显著增加，主要位于额叶和顶叶白质。Cho/NAA比值图显示对变化最敏感，这表明在整个白质中有额外的代谢变化。损伤后代谢变化随时间减少，但在心室周围区域仍有异常值。磁共振成像使用z-score图像分析提供了一种可视化大脑组织代谢弥漫性变化的方法。这种图像可视化方法对于显示广泛和弥漫性代谢变化特别有效，例如由于创伤性损伤。
Brain trauma is known to result in heterogeneous patterns of tissue damage and altered neuronal and glial metabolism that evolve over time following injury; however, little is known on the longitudinal evolution of these changes. In this study, magnetic resonance spectroscopic imaging (MRSI) was used to map the distributions of altered metabolism in a single subject at five time points over a period of 28 months following injury. MRI and volumetric MRSI data was acquired in a subject that had experienced a moderate traumatic brain injury (Glasgow Coma Scale 13) at five time points, from 7 weeks to 28 months after injury. Maps of N-acetylaspartate (NAA), total choline (Cho), and total creatine signal were generated and differences from normal control values identified using a z-score image analysis method. The z-score metabolite maps revealed areas of significantly reduced NAA and increased Cho, predominately located in frontal and parietal white matter, that evolved over the complete course of the study. A map of the ratio of Cho/NAA showed the greatest sensitivity to change, which indicated additional metabolic changes throughout white matter. The metabolic changes reduced over time following injury, though with abnormal values remaining in periventricular regions. The use of z-score image analysis for MRSI provides a method for visualizing diffuse changes of tissue metabolism in the brain. This image visualization method is of particularly effective for visualizing widespread and diffuse metabolic changes, such as that due to traumatic injury.
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