Yifei Mao1,2, Zerui Zhuang3, Yanzi Chen1, Xiaolei Zhang3, Yuanyu Shen1, Guisen Lin1, Renhua Wu1. 1. Department of Medical Imaging, The Second Affiliated Hospital, Medical College of Shantou University, Shantou 515041, China. 2. Department of Radiology, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen 518028, China. 3. Department of Neurosurgery, The Second Affiliated Hospital, Medical College of Shantou University, Shantou 515041, China.
Abstract
BACKGROUND: Chemical exchange saturation transfer (CEST) is an important contrast mechanism in the field of magnetic resonance imaging. Herein, we used CEST for glutamate (GluCEST) imaging to evaluate the Glu alterations in acute mild to moderate traumatic brain injury (TBI) and correlated such alterations with the cognitive outcome at 1-month postinjury. METHODS: Thirty-two patients with well-documented mild-to-moderate TBI and 15 healthy controls (HC group) underwent 3.0-Tesla magnetic resonance imaging (MRI) with GluCEST, and magnetic resonance spectroscopy (MRS) scans. The Montreal Cognitive Assessment (MoCA) examination was administered to all study subjects at 1-month postinjury for cognitive outcome acquisition and divided TBI patients into patients with good cognitive outcome (GCO group) and with poor cognitive outcome (PCO group). RESULTS: The GluCEST% values for the occipital gray matter (OGM) and bilateral parietooccipital white matter (PWM) were higher in the PCO group compared with the HC and GCO groups (P<0.05), whereas the GluCEST% value showed no significant differences between the GCO and HC groups (P>0.05). In comparison with HCs, TBI patients had a significantly increased GluCEST% value for the OGM and bilateral PWM (P<0.05). GluCEST performed better than MRS in the prediction of cognitive outcome for TBI patients (P<0.05). CONCLUSIONS: Glu is significantly increased in acute TBI and strongly correlates with the cognitive outcome at 1month postinjury. GluCEST may supply new insight into TBI and help to improve the accuracy of short-term outcome prediction. 2019 Quantitative Imaging in Medicine and Surgery. All rights reserved.
BACKGROUND: Chemical exchange saturation transfer (CEST) is an important contrast mechanism in the field of magnetic resonance imaging. Herein, we used CEST for glutamate (GluCEST) imaging to evaluate the Glu alterations in acute mild to moderate traumatic brain injury (TBI) and correlated such alterations with the cognitive outcome at 1-month postinjury. METHODS: Thirty-two patients with well-documented mild-to-moderate TBI and 15 healthy controls (HC group) underwent 3.0-Tesla magnetic resonance imaging (MRI) with GluCEST, and magnetic resonance spectroscopy (MRS) scans. The Montreal Cognitive Assessment (MoCA) examination was administered to all study subjects at 1-month postinjury for cognitive outcome acquisition and divided TBI patients into patients with good cognitive outcome (GCO group) and with poor cognitive outcome (PCO group). RESULTS: The GluCEST% values for the occipital gray matter (OGM) and bilateral parietooccipital white matter (PWM) were higher in the PCO group compared with the HC and GCO groups (P<0.05), whereas the GluCEST% value showed no significant differences between the GCO and HC groups (P>0.05). In comparison with HCs, TBI patients had a significantly increased GluCEST% value for the OGM and bilateral PWM (P<0.05). GluCEST performed better than MRS in the prediction of cognitive outcome for TBI patients (P<0.05). CONCLUSIONS: Glu is significantly increased in acute TBI and strongly correlates with the cognitive outcome at 1month postinjury. GluCEST may supply new insight into TBI and help to improve the accuracy of short-term outcome prediction. 2019 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Entities:
Keywords:
Chemical exchange saturation transfer (CEST); cognitive outcome; glutamate (Glu); traumatic brain injury (TBI)
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