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The Clinical Application of 1H-MR Spectrocopy in Multiple Sclerosis

Author: YuanLeiLei
Tutor: ZhaoBin
School: Taishan Medical College
Course: Medical Imaging and Nuclear Medicine
Keywords: H proton magnetic resonance spectroscopy multiple sclerosis metabolism N-acetyiaspartate Choline Creatine
CLC: R744.51
Type: Master's thesis
Year: 2007
Downloads: 21
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ObjectiveTo investigate the appearance and clinical application of 1H-MRS in the brain multiple sclerosis(MS) by studying the difference of metabolic characteristics among lesions, normal appearing white matter(NAWM) in multiple sclerosis and white matter in normal volunteers.Material and methodsThe institutional ethics review board approved study; written informed consent was obtained. Conventional MR imaging were obtained in the 28 patients with relapsing-remitting multiple sclerosis and 25 healthy control subjects. All the subjects were examined by’H-MRS using a 1.5 Tesla whole-body scanner and an eight-channel head coil. The volumes of interest include brain lesions and normal appearing white matter (NAWM) around these lesions on the conventional MRI.The peaks of N-acetyiaspartate (NAA), Choline (Cho), and creatine (Cr) were obtained.The ratios of NAA/Cr and Cho/Cr were obtained and compared with each other and those of control group. Statistical comparisons of data groups were performed by using one-sample/group t-test.RESULTMS has been studied extensively using conventional MRI. H proton magnetic resonance spectroscopy of the volumes of interest were statistics analyzed.The result is:1、Compared with healthy group, there was a significant decrease in the ratio NAA/Cr in the lesions and NAWM (P<0.05). The ratio of Cho/Cr in the lesions and NAWM was obviously elevated (P<0.05).2、Compared with no enhancing lesions,the ratio of NAA/Cr in NAWM was decreased (P<0.05) and there was no significant difference between them in the ratio of Cho/Cr (P>0.05).3、Compared with no enhancing lesions, there was no significant difference in the ratio of NAA/Cr in enhancing lesions (P>0.05), but there was greatly increased in the ratio of Cho/Cr(P<0.05).CONCLUSIONMultiple sclerosis (MS) is a disease of the central nervous system that involves mainly the white matter (WM). Demyelination is believed to be the main pathological process in MS, although the exact mechanisms leading to it are not well understood. Magnetic resonance imaging (MRI) enables detection of lesions in the WM of MS patients, often referred to as MS plaques. However, postmortem histological studies have revealed pathological damage in WM areas that appeared normal in conventional MRI [normal-appearing white matter (NAWM). This damage consisted of, inter alia astrogliosis, blood-brain barrier break down, reduced myelin density and axonal loss.Indeed, in many cases, the disease load as measured by the volume and number of these lesions correlates only poorly with the neurological condition of the patient.Conventional MRI is integral to the diagnosis of MS. Despite the extensive use of MR imaging in multiple sclerosis, there is relatively poor correlation between conventional MR measures of MS lesions burden in functional disability. This may relate to several potential drawbacks of conventional MR imaging. Conventional techniques tend to be insensitive to changes in normal appearing white matter, are typically whole brain imaging techniques which are compared to cortical reorganization and/or adaptation suggested by recent functional MRI studes.1H-MRS can provide specific and quantitative information about two of the major pathologic changes of MS including the active inflammatory/demyelinating process and axonal injury. Active demyelinating process produces changes in the resonances from Cho. Axonal injury and loss can be specific quantified through the decrease of NAA. The NAWM is normal on MRI, but is abnormal on 1H-MRS.It is helpful in diagnosis and differentiation of MS. 1H-MRS offer the potential value for improved diagnosis, better understanding of the underlying mechanisms, improved disease monitoring and guidance of the therapy of MS.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Spinal cord disease > Demyelinating disease > Multiple sclerosis
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