Comparison of magnetic resonance spectroscopy (MRS) with arterial spin labeling (ASL) in the differentiation between mitochondrial encephalomyopathy, lactic Acidosis, plus stroke-like episodes (MELAS) and acute ischemic stroke (AIS)
| Autor: | Bo Li, Yuzhou Wang, Wenming Chen, Yan Xu, Shuisheng Lu, Lina Cheng, Zuying Kuang, Zhanhang Wang, Jianjun Lu, Xiaodi Li, Ziyang Zhou, Mengqiu Pan, Honghao Wang, Jinlong Ye |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Mitochondrial encephalomyopathy medicine.medical_specialty Magnetic Resonance Spectroscopy Cerebral arteries Neuroimaging Brain Ischemia 030218 nuclear medicine & medical imaging 03 medical and health sciences Epilepsy 0302 clinical medicine Physiology (medical) Internal medicine MELAS Syndrome Humans Medicine Acute ischemic stroke Retrospective Studies business.industry General Medicine Middle Aged medicine.disease Stroke Neurology Stroke like episodes Lactic acidosis Arterial spin labeling Cardiology Female Surgery Neurology (clinical) business Perfusion 030217 neurology & neurosurgery |
| Zdroj: | Journal of Clinical Neuroscience. 55:65-70 |
| ISSN: | 0967-5868 |
| DOI: | 10.1016/j.jocn.2018.06.015 |
| Popis: | To compare the utility and limitation of magnetic resonance spectroscopy (MRS) and arterial spin labeling (ASL) in the differentiation between mitochondrial encephalomyopathy, lactic acidosis, plus stroke-like episodes (MELAS) and acute ischemic stroke (AIS), a retrospective review of 17 MELAS and 26 AIS patients were performed. In all patients both MRS and ASL scans were performed within 1 week after admission. Demographic, clinical, laboratory and MR imaging data were reviewed and compared between the two groups. Compared with AIS, MELAS patients had a younger age of onset, a longer disease duration, a higher occurrence of epilepsy attack, occipital and parietal lesions, and dilated cerebral arteries (P 0.05). In all MELAS patients lactate peak and hyperperfusion of the lesion was revealed. However in AIS lactate peak was observed in only 69.2% and hyperperfusion was observed in only 34.6% ischemic lesions (P 0.05). Choline/Creatine ratios and Lactate/Creatine ratios were higher in AIS, while in MELAS cerebral blood flow and lesion-normal perfusion ratio was much higher (P 0.05). No correlations was found between metabolite ratios and perfusion parameters in either group (P 0.05). Area under curve (AUC) of perfusion for the differentiation between MELAS and AIS was 0.958 (P 0.001). The cut-off value was 2.075, with a sensitivity of 88.2% and a specificity of 96.2%. AUC of Lactate/Creatine ratio was 0.469 (P = 0.737). Utility of MRS is limited in the differentiation between MELAS and AIS, while MR perfusion profiles are much more sensitive and specific. |
| Databáze: | OpenAIRE |
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