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Evaluation of multiple sclerosis by 1 H spectroscopic imaging at 4.1 T
Author(s) -
Pan Jullie W.,
Hetherington Hoby P.,
Vaughan J. Thomas,
Mitchell Galen,
Pohost Gerald M.,
Whitaker John N.
Publication year - 1996
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.1910360113
Subject(s) - multiple sclerosis , creatine , choline , lesion , white matter , magnetic resonance imaging , expanded disability status scale , medicine , nuclear medicine , pathology , central nervous system disease , metabolite , hyperintensity , nuclear magnetic resonance , chemistry , radiology , physics , immunology
The authors report on high‐field (4.1 T) magnetic resonance 1 H spectroscopic imaging studies on eight patients with relapsing remitting multiple sclerosis (mean expanded disability status scale (EDSS) 1.0) and eight normal controls. Using T 1 weighted imaging to determine lesion position, the authors found the ratios of choline/ N ‐acetyl (NA) compounds and creatine/NA were increased significantly in the multiple sclerosis (MS) patients relative to controls in lesioned tissue, adjacent to lesion, far removed from lesions as well as in periventricular tissue. The gray matter creatine/NA was mildly increased ( P < 0.01) in the MS patients, whereas the elevated gray‐matter ratio of choline/NA was of borderline significance ( P = 0.13). A more detailed comparison of white‐matter and mean graymatter metabolite values indicates that creatine is increased greatest in areas far from lesions. This is in contrast to choline, which was greatest in lesions, and NA, which was smallest in lesions. It is postulated that the creatine increase may reflect an astrocytic (gliotic) or oligodendrocytic remyelinating process. The increased choline most likely reflects varying levels of inflammation and membrane turnover, whereas the NA decrease is representative of axonal dysfunction or loss.