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Magnetic resonance markers of bilateral neuronal metabolic dysfunction in patients with unilateral internal carotid artery occlusion.
Magnetic Resonance Materials in Physics Biology and Medicine ( IF 2.0 ) Pub Date : 2020-06-27 , DOI: 10.1007/s10334-020-00864-2
Alberto Malucelli 1 , Antonin Skoch 2 , Svapotluk Ostry 3 , Ales Tomek 4 , Barbora Urbanova 4 , Lukas Martinkovic 4 , Irena Buksakowska 5 , Milan Mohapl 6 , David Netuka 6 , Jakub Hort 4 , Jan Sroubek 7 , Jiri Vrana 8 , Tomas Moravec 9 , Robert Bartos 1 , Martin Sames 1 , Milan Hajek 2 , Daniel Horinek 4
Affiliation  

Objectives

To evaluate cerebral hemodynamic, metabolic and anatomic changes occurring in patients with unilateral occlusion of the internal carotid artery (ICA).

Materials and methods

Twenty-two patients with unilateral occlusion of ICA and twenty age and sex matched healthy subjects were included in the study. Single voxel proton magnetic resonance spectroscopy (1H-MRS) of the centrum semiovale, semi-automated hippocampal volumetry in T1-weighted scans and transcranial Doppler examination (TCD) with calculation of Breath Holding Index (BHI) were performed in both groups. Metabolic, anatomic, and hemodynamic features were compared between the two groups.

Results

The N-acetylaspartate (NAA)/choline (Cho) ratio was significantly lower in both hemispheres of enrolled patients compared to controls (p = 0.005 for the side with occlusion, p = 0.04 for the side without occlusion). The hippocampus volume was significantly reduced bilaterally in patients compared to healthy subjects (p = 0.049). A statistically significant difference in BHI values was observed between the side with occlusion and without occlusion (p = 0.037) of the patients, as well as between BHI values of the side with occlusion and healthy volunteers (p = 0.014).

Discussion

Patients with unilateral ICA occlusion have reduced NAA/Cho ratio in the white matter of both hemispheres and have bilateral atrophy of hippocampus. The alteration of hemodynamics alone cannot explain these changes.



中文翻译:

单侧颈内动脉闭塞患者双侧神经元代谢功能障碍的磁共振标志物[J].

目标

评估单侧颈内动脉 (ICA) 闭塞患者的脑血流动力学、代谢和解剖学变化。

材料和方法

22 名单侧 ICA 闭塞患者和 20 名年龄和性别匹配的健康受试者被纳入研究。单体素质子磁共振波谱(1的半卵圆中心H-MRS),在T1加权扫描和颅多普勒检查(TCD)与屏气指数(BHI)的计算半自动海马容量法两组进行。比较两组的代谢、解剖和血流动力学特征。

结果

与对照组相比,入选患者的两个半球的N-乙酰天冬氨酸 (NAA)/胆碱 (Cho) 比率显着降低( 闭塞侧p = 0.005, 无闭塞侧p = 0.04)。与健康受试者相比,患者双侧海马体积显着减少 ( p  = 0.049)。 在患者的闭塞侧和未闭塞侧 ( p = 0.037) 之间,以及在闭塞侧和健康志愿者之间 ( p  = 0.014) ,观察到 BHI 值的统计学显着差异。

讨论

单侧ICA闭塞患者双侧半球白质NAA/Cho比值降低,双侧海马萎缩。仅血流动力学的改变不能解释这些变化。

更新日期:2020-06-27
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