期刊
MAGNETIC RESONANCE IN MEDICINE
卷 50, 期 1, 页码 190-195出版社
JOHN WILEY & SONS INC
DOI: 10.1002/mrm.10481
关键词
brain atrophy; brain MR spectroscopy (MRS); metabolite quantification; multiple sclerosis (MS); proton MRS; relapsing-remitting MS
资金
- NIBIB NIH HHS [EB01015] Funding Source: Medline
- NINDS NIH HHS [NS37739, NS29029] Funding Source: Medline
It is well known that multiple sclerosis (MS) pathogenesis continues even during periods of clinical silence. To quantify the metabolic characteristics of this activity we compared the absolute levels of N-acetylaspartate (NAA), creatine (Cr), and choline (Cho) in the normal-appearing white matter (NAWM) between relapsing-remitting (RR) MS patients and controls. Metabolite concentrations were obtained with 3D proton MR spectroscopy at 1.5 T in a 480 cm(3) volume-of-interest (VOI), centered on the corpus callosum of 11 MS patients and 9 matched controls. Gray/white-matter/cerebral-spinal-fluid (CSF) volumes were obtained from MRI segmentation. Patients' average VOI tissue volume (V-T), 410.8 +/- 24.0 cm(3), and metabolite levels, NAA = 6.33 +/- 0.70, Cr = 4.67 +/- 0.52, Cho = 1.40 +/- 0.17 mM, were different from the controls by -8%, -9%, +22% and +32%. The Cho level was the only single metric differentiating patients from controls at 100% specificity and >90% sensitivity. Diffusely elevated Cho and Cr probably reflect widespread microscopic inflammation, gliosis, or de- and remyelination in the NAWM. Both metabolites are potential prognostic indicators of current disease activity, preceding NAA decline and atrophy. (C) 2003 Wiley-Liss, Inc.
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