Combine MRS With DWI To Evaluate Acute Cerebral Infarction And The Related Clinical

Objective:To observe and analyze the changes of cerebral metabolites in acute cerebral infarction by using Proton magnetic resonance spectroscopy technology,and to analyze the correlation between Proton magnetic resonance spectroscopy and clinical grading.So further explore and assess its clinical value.Methods:There are 51 cases of patients with acute cerebral infarction underwent ~1H-MRS,Diffusion weighted imaging(DWI)and Magnetic Resonance Imaging(MRI)within 72hours after symptom onset.Selected the infracted core and the border area and the contralateral mirror area as region of interest(ROI),N-Acetylaspartate(NAA),Choline(Cho),Lactate(Lac)and Creatine/Phosphocreatine(Cr/PC)in the ROIs were measured to calculate the ratio of NAA and Cr(NAA/Cr)?Lac and Cr(Lac/Cr),and the ratio of concentration of NAA in the ischemic area(iNAA)and contralesional side(iNAA/cNAA).When admitted to hospital all of the patients were performed the National Institute of Health stroke scale(NIHSS)to assess the neurologic deficits.To evaluate clinical outcome,the NIHSS were performed again at a 1-month clinical follow-up.Eventually the relationship between metabolite concentrations and clinical outcome were analyzed.Results:All 51 patients experienced changes in NAA and Lac at different stages after cerebral infraction.In the infraction center,we observed that NAA/Cr decreased(t=2.712,P<0.05),Lac/Cr increased(t=5.431,P<0.05).Compared those with in 24h after strock,the Lac/Cr was found decreased(t=2.241,P<0.05),NAA/Cr decreased(t=2.288,P<0.05)and i NAA/c NAA decreased(t=4.48,P<0.05)within 24 to 72h after stroke in the infraction center.In the broader areas,Lac/Cr was found increased significantly at 72h(P<0.05),but there were not significant changes in NAA/Cr(P>0.05).Follow-up of patients with 40 cases(11 cases were lost to follow-up or unwilling to participate in),the total effective rate of the treatment was 85%according to clinical NIHSS score.the ratio of NAA and Cr was bigger than before the treatment,but the ratio of Lac and Cr was smaller than before the treatment.the Changes in concentrations of Lac and NIHSS score changes were positively correlated,but the changes in concentrations of NAA and NIHSS score changes were negatively correlated.Conclusion:1.~1H-MRS could depict the metabolic changes indicating the pathophysiological process associated with stroke,and could be used to assess the injury severity and treatment effectiveness.2.The changes of NAA and Lac before and after treatment in ~1H-MRS associated with clinical NIHSS score,and could try to evaluate the clinical therapeutic effect.