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Proton Magnetic Resonance Spectroscopy and Gadolinium‐DTPA Perfusion Imaging of Asymptomatic MRI White Matter Lesions
Author(s) -
Oppenheimer Stephen M.,
Nick Bryan R.,
Conturo Thomas E.,
Soher Brian J.,
Preziosi Thomas J.,
Barker Peter B.
Publication year - 1995
Publication title -
magnetic resonance in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.696
H-Index - 225
eISSN - 1522-2594
pISSN - 0740-3194
DOI - 10.1002/mrm.1910330109
Subject(s) - hyperintensity , asymptomatic , magnetic resonance imaging , medicine , white matter , perfusion , creatine , choline , pathology , stroke (engine) , nuclear medicine , radiology , mechanical engineering , engineering
In the elderly, asymptomatic white matter hyperintensities are common on T 2 ‐weighted magnetic resonance imaging (MRI). In symptomatic patients, such MRI appearances correlate with varied postmortem findings including demyelination or stroke. What structural correlates underlie the T 2 hyperintensities in patients whose lesions are asymptomatic is controversial. Therefore, in order to investigate the underlying metabolism and perfusion in white matter lesions (exhibiting T 2 hyperintensity), 13 patients underwent proton magnetic resonance spectroscopy and dynamic gadolinium‐DTPA perfusion‐weighted MR imaging. N‐acetyl aspartate (NA) levels were reduced in the lesions compared with age‐matched controls (P = 0.031), implying neuronal/axonal loss. Creatine levels were also reduced (P = 0.001). Choline levels were unchanged in the lesions. Lactate was identified in the lesions of 5 of the 13 patients. Although not statistically significant, perfusion studies exhibited a trend toward lower cerebral blood volumes in patients with high grade extracranial carotid stenosis and lactate‐containing lesions. These findings suggest that neuronal/axonal loss underlies the majority of T 2 ‐weighted asymptomatic lesions in the older population, and in many cases these changes may be due to chronic ischemia.