The Applied Value Of Proton Magnetic Resonance Spectroscopy In Assessing Clinical Outcome In Acute Stroke

Objective：Analyse the correlation between metabolite concentrations and the clinical outcome,andinvestigate the prognosis value of Proton Magnetic Resonance Spectroscopy(1H-MRS) inacute cerebral infarction.Methods：There are85cases of patients with acute cerebral infarction underwent1H-MRS,Diffusion weighted imaging (DWI) and Magnetic Resonance Imaging (MRI) within72hours after symptom onset. Select the infracted core and the contralateral mirror area asregion of interest(ROI), N-Acetylpartate(NAA), Choline(Cho), Lactate(Lac) andCreatine/Phosphocreatine (Cr/PC) in the ROIs were measured to calculate the ratio of NAAand Cr(NAA/Cr)、Cho and Cr(Cho/Cr)、Lac and Cr(Lac/Cr),and the ratio of concentrationof NAAin the ischemic area (iNAA) and contralesional side(iNAA/cNAA). When admittedto hospital all of the patients were performed the National Institute of Health strokescale(NIHSS) to assesse the neurologic deficits.To evaluate clinical outcome,the NIHSSwere performed again at a6-month clinical follow-up. Eventually the relationship betweenmetabolite concentrations and clinical outcome were analysed. Results：The statistical analysis showed a significant negative correlation between the Lac/NAAinthe infarcted area and the follow-up NIHSS scores (P<0.01)and between the iNAA/cNAAand clinical function recovery (P<0.01).the NAA/Cr in the ischemic area showed a positivecorrelation with the follow-up NIHSS scores(P<0.01). However there was no associationbetween iNAAand the follow-up NIHSS scores(two-sided test P>0.05) and between theCho/Cr and patient outcome(P>0.05).and there was no correlation between Lac and theprognosis and between the iNAA/Cho and clinical outcome.Conclusion:The value of iNAA/iCr, iNAA/cNAAand Lac/iNAAcan be used to estimate the clinicaloutcome and clinical functional recovery in acute stroke. Amore serious clinical situationcan be predicted by low iNAAand high Lac/iNAAin the acute period of stroke. Theclinical outcome and clinical functional recovery can’t be assessed by the value ofNAA、NAA/Cho、Lac and Cho/Cr in the ischemic area.