Document Detail

Application of chemical shift imaging for measurement of NAA in head injured patients.
MedLine Citation:
PMID:  12168350     Owner:  NLM     Status:  MEDLINE    
Neurochemical damage following brain injury can be assessed non-invasively by measurement of N-Acetyl-Aspartate (NAA) using Proton Magnetic Resonance Spectroscopy (1HMRS). This report documents results of applying Chemical Shift Imaging (CSI) postprocessing for measuring NAA in traumatically injured brain. Following stabilization, severely head-injured patients (GCS 8 or less) were transported to the MRI suite. Semi-quantitative measurement of NAA, creatine (Cr/PCr) and choline (Cho) were obtained from single voxels (8 cm3) and CSI for acquisition of smaller voxels (2 cm3) throughout areas of the brain. Studies were completed with no complication. In focal injury, SVS positioned at the site of lesion demonstrated reduced NAA, compared to contralateral hemisphere. In diffuse injury, CSI demonstrated uniform reduction of NAA throughout the brain. NAA/Cho showed normal levels within 24 hours of injury averaging 2.4 and decreased over the next 10 days reaching a plateau of 0.75. At 30 days, NAA showed no recovery in poor outcome patients. In patients with good outcome, NAA initially low recovered near baseline levels. CSI provides a comprehensive neurochemical assessment of neuronal damage. NAA decreases and remains low in patients with poor outcome. NAA recovers in patients with favorable outcome, suggesting marginal metabolic impairment and possible re-synthesis of the NAA pool.
S Signoretti; A Marmarou; P Fatouros; R Hoyle; A Beaumont; S Sawauchi; R Bullock; H Young
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  81     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2002  
Date Detail:
Created Date:  2002-08-09     Completed Date:  2003-01-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  373-5     Citation Subset:  IM    
Division of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, USA.
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MeSH Terms
Aspartic Acid / analogs & derivatives*,  metabolism*
Biological Markers / analysis
Brain Injuries / diagnosis,  metabolism,  surgery*
Choline / metabolism
Creatinine / metabolism
Magnetic Resonance Imaging
Monitoring, Intraoperative / methods
Neurochemistry / methods
Reference Values
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Biological Markers; 56-84-8/Aspartic Acid; 60-27-5/Creatinine; 62-49-7/Choline; 997-55-7/N-acetylaspartate

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