CEREBRAL METABOLITES IN PATIENTS WITH ACUTE AND SUBACUTE STROKES - CONCENTRATIONS DETERMINED BY QUANTITATIVE PROTON MR SPECTROSCOPY

OBJECTIVE. The purpose of this study was to determine the feasibility of measuring concentrations of cerebral metabolites in acute and subac ute stroke patients using single-voxel localized proton MR spectroscop y and to compare these concentrations to those in contralateral brain regions and in normal healthy volunteers. SUBJECTS AND METHODS. Single -voxel proton MR spectroscopy and MR imaging were performed in 14 stro ke patients, at times ranging from 2 hr to 10 days following the onset of symptoms, Signals from choline, creatine, N-acetyl-L-aspartate (NA A), and lactate were quantified in the infarcted region (n = 14) and i n the hemisphere contralateral to the stroke (n = 8) and compared with data obtained from a group of 10 control subjects. RESULTS. Infarcts were characterized by significantly increased lactate (12 of 14 patien ts; 7.5 +/- 8.9 mu mol/g wet weight, mean +/- SD) and significantly de creased NAA (12 of 14 patients; 5.5 +/- 3.2 mu mol/g wet weight), comp ared with contralateral brain regions and control data in healthy volu nteers, Significant reductions in choline, creatine, and NAA were also found in contralateral brain regions compared with the control patien ts. CONCLUSION. Quantitative single-voxel proton spectroscopy is feasi ble for use in clinical studies of acute stroke, Ratio measurements or comparison with contralateral metabolites may be misleading because a ll metabolites may change during infarction, and contralateral metabol ite levels may also be different from normal subjects.