Persistent high lactate level as a sensitive MR spectroscopy indicator of completed infarction

1990 ◽  
Vol 72 (5) ◽  
pp. 763-766 ◽  
Author(s):  
Kiyohiro Houkin ◽  
Ingrid L. Kwee ◽  
Tsutomu Nakada
Keyword(s):  
Magnetic Resonance ◽  
Cerebral Infarction ◽  
Mr Spectroscopy ◽  
The Other ◽  
Proton Spectroscopy ◽  
Normal Pattern ◽  
Content Type ◽  
Lactate Levels ◽  
High Lactate ◽  
Fine Print

✓ Serial proton (1H) and phosphorus-31 (31P) magnetic resonance (MR) spectroscopy of cerebral infarction was performed in rats to assess the sensitivity of these techniques for use in clinical cerebral infarction. In this experimental chronic infarction model, 31P spectroscopy tended to return to a “normal” pattern within 24 hours after induction of infarction in spite of pathologically proven completed infarction and, therefore, appeared not to be sensitive enough for clinical application. On the other hand, proton spectroscopy invariably showed persistent high lactate levels and was capable of distinguishing completed infarction from reperfused recovered brain. Persistent high lactate levels appear to be a good MR spectroscopic indicator of completed infarction.

Percutaneous endoscopic treatment of suprasellar arachnoid cysts: ventriculocystostomy or ventriculocystocisternostomy?

1996 ◽  
Vol 84 (4) ◽  
pp. 696-701 ◽  
Author(s):  
Philippe Decq ◽  
Pierre Brugières ◽  
Caroline Le Guerinel ◽  
Michel Djindjian ◽  
Yves Kéravel ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Flow Dynamics ◽  
The Other ◽  
Arachnoid Cysts ◽  
Csf Flow ◽  
Content Type ◽  
Secondary Closure ◽  
Fine Print

✓ The use of an endoscope in the treatment of suprasellar arachnoid cysts provides an opening of the upper and lower cyst walls, thereby allowing the surgeon to perform a ventriculocystostomy (VC) or a ventriculocystocysternostomy (VCC). To discover which procedure is appropriate, magnetic resonance (MR)—imaged cerebrospinal fluid (CSF) flow dynamics in two patients were analyzed, one having undergone a VC and the other a VCC using a rigid endoscope. Magnetic resonance imaging studies were performed before and after treatment, with long-term follow-up periods (18 months and 2 years). The two patients were reoperated on during the follow-up period because of slight headache recurrence in one case and MR—imaged CSF flow dynamics modifications in the other. In each case surgery confirmed the CSF flow dynamics modifications appearing on MR imaging. In both cases, long-term MR imaging follow-up studies showed a secondary closing of the upper wall orifice. After VCC, however, the lower communication between the cyst and the cisterns remained functional. The secondary closure of the upper orifice may be explained as follows: when opened, the upper wall becomes unnecessary and tends to return to a normal shape, leading to a secondary closure. The patent sylvian aqueduct aids this phenomenon, as observed after ventriculostomy when the aqueduct is secondarily functional. The simplicity of the VCC performed using endoscopic control, which is the only procedure to allow the opening in the cyst's lower wall to remain patent, leads the authors to advocate this technique in the treatment of suprasellar arachnoid cysts.

High-resolution 1H-magnetic resonance spectroscopy of pediatric posterior fossa tumors in vitro

1994 ◽  
Vol 81 (3) ◽  
pp. 443-448 ◽  
Author(s):  
Leslie N. Sutton ◽  
Suzanne L. Wehrli ◽  
Laura Gennarelli ◽  
Zhiyue Wang ◽  
Robert Zimmerman ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
High Resolution ◽  
Posterior Fossa ◽  
Mr Spectroscopy ◽  
Resonance Spectroscopy ◽  
Content Type ◽  
Primitive Neuroectodermal Tumors ◽  
Neuroectodermal Tumors ◽  
Fine Print

✓ High-resolution proton magnetic resonance (MR) spectroscopy was performed on perchlorate extracts of tumors (24 cases) or peritumoral vermis (five cases) obtained at surgery. Fifteen tumors were typical cerebellar astrocytomas and nine were posterior fossa primitive neuroectodermal tumors/medulloblastomas. Spectra obtained from the five samples of peritumoral vermis revealed a pattern of metabolites similar to that reported for cerebellar tissue, but concentrations of most metabolites were low, perhaps due to dilution from peritumoral edema. The astrocytomas were characterized by high levels of valine, alanine, and choline, an increase in the choline:N-acetylaspartate (NAA) ratio, and a shift from glutamate to glutamine. Elevations in lactate, pyruvate, and glucose were the result of ischemia during sampling. The primitive neuroectodermal tumors/medulloblastomas were distinguished from astrocytomas by a greater increase in the choline:NAA ratio, a smaller decrease in the glutamate:glutamine ratio, and a relative increase in glycine, taurine, and inositol levels. These metabolic patterns may be of value diagnostically as in vivo MR spectroscopy achieves higher resolution.

Assessment of cerebral S100B levels by proton magnetic resonance spectroscopy after lateral fluid-percussion injury in the rat

2005 ◽  
Vol 102 (6) ◽  
pp. 1115-1121 ◽  
Author(s):  
Andrea Kleindienst ◽  
Christos M. Tolias ◽  
Frank D. Corwin ◽  
Christian Müller ◽  
Anthony Marmarou ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Spectroscopy ◽  
Proton Magnetic Resonance ◽  
Proton Mr Spectroscopy ◽  
Content Type ◽  
Serum S100b ◽  
Fluid Percussion ◽  
Fluid Percussion Injury ◽  
Lateral Fluid Percussion ◽  
Fine Print

Object. After traumatic brain injury (TBI), S100B protein is released by astrocytes. Furthermore, cerebrospinal fluid (CSF) and serum S100B levels have been correlated to outcome. Given that no data exist about the temporal profile of cerebral S100B levels following TBI and their correlation to serum levels, the authors examined whether proton magnetic resonance (MR) spectroscopy is capable of measuring S100B. Methods. Results of in vitro proton MR spectroscopy experiments (2.35-tesla magnet, 25 G/cm, point-resolved spatially localized spectroscopy) revealed an S100B-specific peak at 4.5 ppm and confirmed a positive correlation between different S100B concentrations (10 nM–1 µM) and the area under the curve (AUC) for the S100B peak (r = 0.991, p < 0.001). Thereafter, proton MR spectroscopy was performed in male Sprague—Dawley rats (7 × 5 × 5—mm voxel in each hemisphere, TR 3000 msec, TE 30 msec, 256 acquisitions). Exogenously increased CSF S100B levels (∼ 200 ng/ml) through the intraventricular infusion of S100B increased the AUC of the S100B peak from 0.06 ± 0.02 to 0.44 ± 0.06 (p < 0.05), whereas serum S100B levels remained normal. Two hours after lateral fluid-percussion injury, serum S100B levels increased to 0.61 ± 0.09 ng/ml (p < 0.01) and rapidly returned to normal levels, whereas the AUC of the S100B peak increased to 0.19 ± 0.04 at 2 hours postinjury and 0.41 ± 0.07 (p < 0.05) on Day 5 postinjury. Conclusions. Proton MR spectroscopy proves a strong correlation between the AUC of the S100B peak and S100B concentrations. Following experimental TBI, serum S100B levels increased for only a very short period, whereas cerebral S100B levels were increased up to Day 5 postinjury. Given that experimental data indicate that S100B is actively released following TBI, proton MR spectroscopy may represent a new tool to identify increased cerebral S100B levels in patients after injury, thus allowing its biological function to be better understood.

Patterns of lateral sensory cortical activation determined using functional magnetic resonance imaging

1998 ◽  
Vol 89 (5) ◽  
pp. 769-779 ◽  
Author(s):  
Charles J. Hodge ◽  
Sean C. Huckins ◽  
Nikolaus M. Szeverenyi ◽  
Michael M. Fonte ◽  
Jacob G. Dubroff ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Imaging Techniques ◽  
Cortical Activation ◽  
The Other ◽  
Functional Magnetic Resonance ◽  
Cortical Function ◽  
Content Type ◽  
And Cluster Analysis ◽  
Student’S T ◽  
Fine Print

Object. Functional magnetic resonance (fMR) imaging was performed in human volunteers to determine the lateral perisylvian cortical areas activated by innocuous cutaneous stimulation. Methods. Eight volunteers who underwent 53 separate experiments form the basis of this report. Eight contiguous coronal slices were obtained using echoplanar fMR imaging techniques while participants were at rest and while somatosensory activation stimuli consisting of vibration or air puffs were delivered to various body areas. The data were analyzed using Student's t-test and cluster analysis to determine significant differences between the resting and activated states. The findings were as follows: the areas in the lateral cortex activated by the sitmuli were the primary sensory cortex (SI), the second somatosensory area (SII), the insula, the superior parietal lobule, and the retroinsular parietal operculum (RIPO). Somatotopy was demonstrable in SI but not in the other areas identified. There was a surprisingly low correlation between the amount of cortex activated in the various areas, which could mean separate inputs and functions for the areas identified. The highest correlation was found between activity in SII and RIPO (0.69). Conclusions. The authors maintain that fMR imaging can be used to identify multiple lateral somatosensory areas in humans. Somatotopy is demonstrated in SI but not in the other lateral cortical sensory areas. The correlations between the amounts of cortex activated in the different lateral sensory areas are low. Recognition of the multiple lateral sensory areas is important both for understanding sensory cortical function and for safe interpretation of studies designed to identify the central sulcus by activating SI.

Noninvasive evaluation of the malignant potential of intracranial meningiomas performed using proton magnetic resonance spectroscopy

1999 ◽  
Vol 91 (6) ◽  
pp. 928-934 ◽  
Author(s):  
Akihiko Shiino ◽  
Satoshi Nakasu ◽  
Masayuki Matsuda ◽  
Jyoji Handa ◽  
Shigehiro Morikawa ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Spectroscopy ◽  
Tumor Grade ◽  
Resonance Spectroscopy ◽  
Proton Mr Spectroscopy ◽  
Content Type ◽  
The Mean ◽  
Benign Group ◽  
Fine Print ◽  
Mib 1

Object. Controversy exists about correlations between histological tumor grade and magnetic resonance (MR) spectroscopy data. The authors studied single-voxel proton MR spectroscopy as a noninvasive way to evaluate grade of malignancy in intracranial meningiomas.Methods. The authors compared the results of MR spectroscopy with those derived by the MIB-1 staining index (SI) in 29 meningiomas. Proton MR spectroscopy was performed using stimulated echo acquisition and volume-localized solvent-attenuated proton nuclear MR sequences before surgery or other therapy.Twenty-four tumors were histologically benign (13 meningothelial, three fibrous, four transitional, three angiomatous, and one chordoid); four were atypical (Grade II), and one was papillary (Grade III). The mean MIB-1 SI in the benign group was significantly lower than those in the other groups (p = 0.0041). The mean choline-containing compound (Cho)/creatine and phosphocreatine (Cr) ratios in the benign and nonbenign groups were 2.56 ± 1.26 and 7.85 ± 3.23, respectively (p = 0.0002). A significant linear correlation was observed between the Cho/Cr ratio and the MIB-1 SI (r0.05 = 0.74, p < 0.001). Necrosis was present histologically in four of the five meningiomas classified either as atypical or papillary. Magnetic resonance spectroscopy revealed a methylene signal in these meningiomas that was not detected in benign meningiomas. Of the five meningiomas in which only a lactate signal was observed, two were benign and the MIB-1 SI in these two benign meningiomas was higher than the mean value for the benign group. Alanine, detected in 12 of 30 meningiomas, did not correlate with either tumor grade or Cho/Cr ratio.Conclusions. Proton MR spectroscopy is a useful diagnostic method for determining the proliferative or malignant potential of meningiomas according to the Cho/Cr ratio. A lactate and/or methylene signal suggests a high-grade tumor.

Cerebral metabolism in experimental hydrocephalus: an in vivo 1H and 31P magnetic resonance spectroscopy study

1999 ◽  
Vol 91 (4) ◽  
pp. 660-668 ◽  
Author(s):  
Kees P. J. Braun ◽  
Pieter van Eijsden ◽  
W. Peter Vandertop ◽  
Robin A. de Graaf ◽  
Rob H. J. M. Gooskens ◽  
...  
Keyword(s):  
Energy Metabolism ◽  
Magnetic Resonance ◽  
Mr Spectroscopy ◽  
Neuronal Damage ◽  
Lactate Production ◽  
Cerebral Damage ◽  
Adult Rats ◽  
Content Type ◽  
Fine Print

Object. Brain damage in patients with hydrocephalus is caused by mechanical forces and cerebral ischemia. The severity and localization of impaired cerebral blood flow and metabolism are still largely unknown. Magnetic resonance (MR) spectroscopy offers the opportunity to investigate cerebral energy metabolism and neuronal damage noninvasively and longitudinally. Previous 1H MR spectroscopy studies have shown an increased lactate resonance that is suggestive of anaerobic glycolysis. The aim of this study was to assess cerebral damage and energy metabolism in kaolin-induced hydrocephalus in adult rats by using in vivo 1H and 31P MR spectroscopy. The presence of lactate was correlated with high-energy phosphate metabolism and intracellular pH. The measurement of relative concentrations of N-acetyl aspartate (NAA), choline (Cho), and total creatine (tCr) served to assess neuronal damage.Methods. Hydrocephalus was induced in adult rats by surgical injection of kaolin into the cisterna magna. Magnetic resonance studies, using a 4.7-tesla magnet, were performed longitudinally in hydrocephalic animals at 1 (10 rats), 8 (six rats), and 16 weeks (six rats) thereafter, as well as in eight control animals. To evaluate ventricular size and white matter edema T2-weighted MR imaging was performed. The 1H MR spectra were acquired from a 240-µl voxel, positioned centrally in the brain, followed by localized 31P MR spectroscopy on a two-dimensional column that contained the entire brain but virtually no extracranial muscles. The 1H and 31P MR spectroscopy peak ratios were calculated after fitting the spectra in the time domain, intracellular pH was estimated from the inorganic phosphate (Pi) chemical shift, and T2 relaxation times of 1H metabolites were determined from the signal decay at increasing echo times.Conclusions. In hydrocephalic rats, ventricular expansion stabilized after 8 weeks. White matter edema was most pronounced during acute hydrocephalus. Lactate peaks were increased at all time points, without a decrease in phosphocreatine (PCr)/Pi and PCr/adenosine triphosphate (ATP) peak ratios, or pH. Possibly lactate production is restricted to periventricular brain tissue, followed by its accumulation in cerebrospinal fluid, which is supported by the long lactate T2 relaxation time. Alternatively, lactate production may precede impairment of ATP homeostasis. The NAA/Cho and tCr/Cho ratios significantly decreased during the acute and chronic stages of hydrocephalus. These changes were not caused by alterations in metabolite T2 relaxation time. The decreases in the NAA/Cho and tCr/Cho ratios implicate neuronal loss/dysfunction or changes in membrane phospholipid metabolism, as in myelin damage or gliosis. It is suggested that 1H MR spectroscopy can be of additional value in the assessment of energy metabolism and cerebral damage in clinical hydrocephalus.

Integration of biochemical images of a tumor into frameless stereotaxy achieved using a magnetic resonance imaging/magnetic resonance spectroscopy hybrid data set

2004 ◽  
Vol 101 (2) ◽  
pp. 287-294 ◽  
Author(s):  
Andreas Stadlbauer ◽  
Ewald Moser ◽  
Stephan Gruber ◽  
Christopher Nimsky ◽  
Rudolf Fahlbusch ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Mr Spectroscopy ◽  
Frameless Stereotaxy ◽  
Low Grade ◽  
Normal Brain ◽  
Tumor Infiltration ◽  
Data Set ◽  
Content Type ◽  
Fine Print

Object. It is often difficult to delineate the extent of invasion of high- and low-grade gliomas into normal brain tissue by using conventional T1- and T2-weighted magnetic resonance (MR) imaging. Knowledge of the relationship between the tumor infiltration zone and normal brain, however, is one of the prerequisites for performing as radical a tumor resection as possible. Proton MR spectroscopy allows noninvasive measurements of the concentrations and spatial distributions of brain metabolites and, therefore, may provide biochemical information in vivo, that is useful in distinguishing pathological from normal areas of the brain. The authors have developed a method to use the properties of MR spectroscopy to investigate intraoperatively pathological changes in the spatial distribution of choline (Cho)-containing compounds, total creatine, and N-acetylaspartate (NAA) in brain tumors with the aid of frameless stereotaxy. Methods. Maps of the Cho/NAA ratio were calculated and automatic segmentation of the tumors was performed. Spectroscopic images of the segmented tumor were matched to an anatomical three-dimensional (3D) MR imaging set by applying a fully automated mutual-information algorithm. The resulting 3D MR image can be used subsequently for neurosurgical planning, transfer to a frameless stereotactic system, and display in the navigation microscope during surgery leading to 1H-MR spectroscopy-guided navigation. Conclusions. This method may allow better intraoperative identification of tumor border zones based on metabolic changes due to tumor infiltration.

Use of proton magnetic resonance spectroscopy of the brain to differentiate gliomatosis cerebri from low-grade glioma

2003 ◽  
Vol 98 (2) ◽  
pp. 269-276 ◽  
Author(s):  
Damien Galanaud ◽  
Olivier Chinot ◽  
François Nicoli ◽  
Sylviane Confort-Gouny ◽  
Yann Le Fur ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Spectroscopy ◽  
Proton Magnetic Resonance ◽  
Cellular Proliferation ◽  
Gliomatosis Cerebri ◽  
Resonance Spectroscopy ◽  
Low Grade ◽  
Metabolic Pattern ◽  
Content Type ◽  
Fine Print

Object. Gliomatosis cerebri (GC), a rare entity characterized by a widespread infiltration of brain by tumor, lacks objective and quantitative diagnostic criteria. Single-voxel spectroscopy and chemical shift imaging (two-dimensional proton magnetic resonance [MR] spectroscopy) were performed using both short (20- or 22-msec) and long (135-msec) echo times in nine patients suffering from GC, nine patients with low-grade gliomas (LGGs), and 25 healthy volunteers to establish the precise metabolic pattern of this uncommon brain neoplasm. Methods. The gliomatosis infiltration was characterized by markedly elevated levels of creatine—phosphocreatine (Cr) and myo-inositol (Ins), a reduced level of N-acetyl aspartate (NAA), and a moderately elevated level of choline-containing compounds (Cho). This pattern differs strikingly from LGGs, which are characterized by elevated levels of Cho and Ins, markedly reduced levels of NAA, and low-to-normal Cr concentrations. Although the distinction between GC and LGG, based on histological and MR imaging criteria, is a matter of debate, MR spectroscopy produces valuable information for the differentiation between these two entities and, hence, the choice of therapeutic strategy. It also provides new insight into the pathophysiology of GC because elevated Cr and Ins levels may be related to proliferation of glial elements or, more probably, activation of normal glia. Elevated levels of Cho reflect cellular proliferation and reduced NAA corresponds to reversible neuronal injury and/or focal invasion by the tumor process. Conclusions. Owing to the unfavorable clinical outcome associated with GC compared with that associated with LGG, the findings of this study illustrate the diagnostic and prognostic value of proton MR spectroscopy in the characterization of infiltrating gliomas.

Possible origin of suprasellar arachnoid cysts: neuroimaging and neurosurgical observations in nine cases

2000 ◽  
Vol 93 (1) ◽  
pp. 62-67 ◽  
Author(s):  
Masakazu Miyajima ◽  
Hajime Arai ◽  
Osamu Okuda ◽  
Makoto Hishii ◽  
Hajime Nakanishi ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Ventral Surface ◽  
The Other ◽  
Arachnoid Cysts ◽  
Content Type ◽  
Interpeduncular Cistern ◽  
Endoscopic Observation ◽  
Different Types ◽  
Early Filling ◽  
Fine Print

Object. In this study the authors identify and investigate two new classifications of suprasellar arachnoid cysts.Methods. The authors used computerized tomography cisternography, magnetic resonance (MR) imaging, and neuroendoscopy to investigate nine cases of suprasellar arachnoid cysts. A communicating cyst with early filling and early clearance of a radioopaque tracer was found in seven of nine cases; a communicating cyst with delayed filling and delayed clearance of the tracer was observed in one case; and a noncommunicating cyst was observed in the other. The MR findings indicated a variation in the position of the basilar artery (BA) bifurcation in relation to the ventral surface of the midbrain. A distance existed between the BA bifurcation and the ventral surface of the midbrain in a communicating cyst with early filling, whereas the BA bifurcation was posteriorly displaced in a communicating cyst with delayed filling and also in a noncommunicating cyst, leaving little space between the bifurcation and the ventral surface of the midbrain. Endoscopic observation revealed, in the case of communicating cysts with early filling and early clearance of tracer, that the BA bifurcation is located inside the cyst with no overlying membrane, whereas in a noncommunicating cyst, the BA and its branches can be observed through the transparent membrane of the lesion.Conclusions. The authors postulate two different types of suprasellar arachnoid cysts: a noncommunicating intraarachnoid cyst of the diencephalic membrane of Liliequist and a communicating cyst that is a cystic dilation of the interpeduncular cistern.

Histopathological validation of a three-dimensional magnetic resonance spectroscopy index as a predictor of tumor presence

2002 ◽  
Vol 97 (4) ◽  
pp. 794-802 ◽  
Author(s):  
Tracy R. McKnight ◽  
Mary H. von dem Bussche ◽  
Daniel B. Vigneron ◽  
Ying Lu ◽  
Mitchel S. Berger ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Mr Spectroscopy ◽  
Surgical Navigation ◽  
Three Dimensional ◽  
Correlation Study ◽  
Receiver Operating Curve ◽  
Resonance Spectroscopy ◽  
Hyperintense Lesion ◽  
Content Type ◽  
Fine Print

Object. Data obtained preoperatively from three-dimensional (3D)/proton magnetic resonance (MR) spectroscopy were compared with the results of histopathological assays of tissue biopsies obtained during surgery to verify the sensitivity and specificity of a choline-containing compound—N-acetylaspartate index (CNI) used to distinguish tumor from nontumorous tissue within T2 hyperintense and contrast-enhancing lesions of patients with untreated gliomas. The information gleaned from the biopsy correlation study was used to test the hypothesis that there is metabolically active tumor in nonenhancing regions of the T2-hyperintense lesion that can be detected using MR spectroscopy. Methods. Patients suspected of harboring a glioma underwent 3D MR spectroscopy during their preoperative MR imaging examination. Surgical navigation techniques were used to record the location of tissue biopsies collected during open resection of the tumor. A receiver operating curve analysis of the CNI and histological characteristics of specimens at each biopsy location was performed to determine the optimal threshold of the CNI required to separate tumor from nontumorous tissue. Histograms of the CNIs within enhancing and nonenhancing regions of lesions appearing on MR images were generated to determine the spatial distribution of CNIs consistent with tumor. Conclusions. Biopsy samples containing tumor were distinguished from those containing a mixture of normal, edematous, gliotic, and necrotic tissue with 90% sensitivity and 86% specificity by using a CNI threshold of 2.5. The CNIs of nontumorous specimens were significantly different from those of biopsy specimens containing Grade II (p < 0.03), Grade III (p < 0.005), and Grade IV (p < 0.01) tumors. On average, one third to one half of the T2-hyperintense lesion outside the contrast-enhancing lesion contained CNI greater than 2.5.

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