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Proton magnetic resonance spectroscopy of late delayed radiation‐induced injury of the brain
Author(s) -
Chan Yuleung,
Yeung David K.W.,
Leung Singfai,
Cao Guang
Publication year - 1999
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/(sici)1522-2586(199908)10:2<130::aid-jmri4>3.0.co;2-r
Subject(s) - creatine , medicine , metabolite , magnetic resonance imaging , proton magnetic resonance , choline , pathophysiology , pathology , necrosis , radiation injury , nuclear medicine , radiation therapy , nuclear magnetic resonance , radiology , physics
We prospectively evaluated metabolite changes in late delayed radiation‐induced injury to the temporal lobes on proton ( 1 H) magnetic resonance spectroscopy (MRS) in 34 patients. Morphologically more severe injury on imaging tended to have lower N ‐acetyl aspartate (NAA)/creatine (Cr) and NAA/choline (Cho) ratios. A significantly higher Cho/Cr ratio was found in the most severe grade of cerebral necrosis, in which lactate might be present. The progressive decrease in NAA with increasing severity reflected neuronal loss at different stages of late delayed radiation‐induced brain injury. The absence of Cho elevation in mild and moderate lesions did not suggest demyelination or glial hyperplasia as an etiologic mechanism of late delayed radiation‐induced brain injury. The association of severe morphologic lesions with elevated lactate suggests ischemia as the underlying mechanism for severe lesions. 1 H MRS may provide metabolite information conducive to the understanding of the pathophysiology of late radiation‐induced brain injury. J. Magn. Reson. Imaging 1999;10:130–137. © 1999 Wiley‐Liss, Inc.