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Journal of the Korean Academy of Rehabilitation Medicine 2000;24(5):842-849.
Usefulness of 1H MR Spectroscopy for Detection of Diffuse Axonal Injury in the Traumatic Brain Injured Patients
Yoon, Se Jin , Kim, Sang Tae , Lee, Jung Hee , Chun, Min Ho
1Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine.
2NMR Laboratory, Asan Institute for Life Sciences.
외상성 뇌손상시 미만성 축색손상에 대한 1H MR Spectroscopy의 유용성
윤세진, 김상태1, 이정희1, 전민호
울산대학교 의과대학 서울중앙병원 재활의학과, 1아산생명과학연구소 자기공명연구실

The purpose of this study was to determine whether 1H magnetic resonance spectroscopy (MRS) is a potential tool for the detection of microscopic diffuse axonal injury (DAI) and for the evaluation of functional status of patients with traumatic brain injury (TBI).

Seven patients with severe TBI and fourteen normal control volunteers were examined. Image guided spectra of localized in vivo 1H MRS were obtained from parietal white matter (PWM) and occipital gray matter (OGM) in which definite abnormality was not detected in MR imaging. The severity of TBI was evaluated by the initial Glasgow Coma Scale (GCS), and the functional status was evaluated by Functional Independence Measure (FIM) at the time of the MRS examination, approximately 2 months after onset.

In PWM, the [N-acetylaspartate(NAA)/Creatine(Cr)] ratio was significantly lower, and the [Choline(Cho)/Cr] and [myo-Inositol(mI)/Cr] ratios were significantly higher in the patients with TBI than those of normal volunteers. There was no significant correlation between the ratios of metabolites and GCS scores. However, interestingly, a significant correlation between the [NAA/Cr] ratio in PWM and the FIM scores was observed.

We could conclude that decreased [NAA/Cr], increased [Cho/Cr], and increased [mI/Cr] ratios in PWM can be considered as markers for DAI. Localized 1H MRS has a potential to be used for the detection of DAI in vivo and evaluation of functional status of the patients with TBI.

Key Words: Traumatic brain injury, Magnetic resonance spectroscopy, Functional Independence Measure, Glasgow Coma Scale


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