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<meta name="DC.Title" content="Magnetization Transfer Imaging and Proton MR Spectroscopy in the Evaluation of Axonal Injury: Correlation with Clinical Outcome after Traumatic Brain Injury" />
<meta name="DC.Date" content="2001-01-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Current imaging does not permit quantification of neural injury after traumatic brain injury (TBI) and therefore limits both the development of new treatments and the appropriate counseling of patients concerning prognosis. We evaluated the utility of magnetization transfer ratio (MTR) and proton MR spectroscopy in identifying patients with neuronal injury after TBI.

METHODS: Thirty patients with TBI (21–77 years old; mean age, 42 years; admission Glasgow Coma Scale (GOS) scores 3–15; mean score, 11) were studied on a 1.5-T system with magnetization transfer imaging and MR spectroscopy of the splenium. Magnetization transfer imaging was also performed in the brain stem in all patients, and other areas of the brain were sampled in one patient. The splenium of the corpus callosum and brain stem were studied because these are often affected by diffuse axonal injury. Scans were obtained 2 to 1129 days after injury (median, 41 days). MTR was considered abnormal if it was more than 2 SD below normal. Proton MR spectroscopy was used to calculate the N -acetylaspartate (NAA)/creatine (Cr) ratio. GOS was determined at least 3 months after injury.

RESULTS: In 10 patients with a GOS of 1 to 4, the mean NAA/Cr was 1.24 ± 0.28; two of these patients had abnormal MTR in normal-appearing white matter (NAWM). In 20 patients with a GOS of 5, the mean NAA/Cr was 1.53 ± 0.37 ( P &lt; .05); four of these patients had abnormal MTR in NAWM. MTR abnormalities in NAWM were identified in six patients, but these changes did not correlate with GOS or MR spectroscopy changes.

CONCLUSION: MTR and MR spectroscopy can quantify damage after TBI, and NAA levels may be a sensitive indicator of the neuronal damage that results in a worse clinical outcome." />
<meta name="DC.Contributor" content="Grant Sinson" />
<meta name="DC.Contributor" content="Linda J. Bagley" />
<meta name="DC.Contributor" content="Kim M. Cecil" />
<meta name="DC.Contributor" content="Maria Torchia" />
<meta name="DC.Contributor" content="Joseph C. McGowan" />
<meta name="DC.Contributor" content="Robert E. Lenkinski" />
<meta name="DC.Contributor" content="Tracy K. McIntosh" />
<meta name="DC.Contributor" content="Robert I. Grossman" />
<meta name="article:published_time" content="2001-01-01" />
<meta name="article:section" content="BRAIN" />
<meta name="citation_title" content="Magnetization Transfer Imaging and Proton MR Spectroscopy in the Evaluation of Axonal Injury: Correlation with Clinical Outcome after Traumatic Brain Injury" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;i&gt;BACKGROUND AND PURPOSE:&lt;/i&gt; Current imaging does not permit quantification of neural injury after traumatic brain injury (TBI) and therefore limits both the development of new treatments and the appropriate counseling of patients concerning prognosis. We evaluated the utility of magnetization transfer ratio (MTR) and proton MR spectroscopy in identifying patients with neuronal injury after TBI.&lt;/p&gt;&lt;p&gt;&lt;i&gt;METHODS:&lt;/i&gt; Thirty patients with TBI (21–77 years old; mean age, 42 years; admission Glasgow Coma Scale (GOS) scores 3–15; mean score, 11) were studied on a 1.5-T system with magnetization transfer imaging and MR spectroscopy of the splenium. Magnetization transfer imaging was also performed in the brain stem in all patients, and other areas of the brain were sampled in one patient. The splenium of the corpus callosum and brain stem were studied because these are often affected by diffuse axonal injury. Scans were obtained 2 to 1129 days after injury (median, 41 days). MTR was considered abnormal if it was more than 2 SD below normal. Proton MR spectroscopy was used to calculate the &lt;i&gt;N&lt;/i&gt;-acetylaspartate (NAA)/creatine (Cr) ratio. GOS was determined at least 3 months after injury.&lt;/p&gt;&lt;p&gt;&lt;i&gt;RESULTS:&lt;/i&gt; In 10 patients with a GOS of 1 to 4, the mean NAA/Cr was 1.24 ± 0.28; two of these patients had abnormal MTR in normal-appearing white matter (NAWM). In 20 patients with a GOS of 5, the mean NAA/Cr was 1.53 ± 0.37 (&lt;i&gt;P&lt;/i&gt; &amp;lt; .05); four of these patients had abnormal MTR in NAWM. MTR abnormalities in NAWM were identified in six patients, but these changes did not correlate with GOS or MR spectroscopy changes.&lt;/p&gt;&lt;p&gt;&lt;i&gt;CONCLUSION:&lt;/i&gt; MTR and MR spectroscopy can quantify damage after TBI, and NAA levels may be a sensitive indicator of the neuronal damage that results in a worse clinical outcome.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2001/01/01" />
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<meta name="citation_author" content="Grant Sinson" />
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<meta name="twitter:title" content="Magnetization Transfer Imaging and Proton MR Spectroscopy in the Evaluation of Axonal Injury: Correlation with Clinical Outcome after Traumatic Brain Injury" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Current imaging does not permit quantification of neural injury after traumatic brain injury (TBI) and therefore limits both the development of new treatments and the appropriate counseling of patients concerning prognosis. We evaluated the utility of magnetization transfer ratio (MTR) and proton MR spectroscopy in identifying patients with neuronal injury after TBI.

METHODS: Thirty patients with TBI (21–77 years old; mean age, 42 years; admission Glasgow Coma Scale (GOS) scores 3–15; mean score, 11) were studied on a 1.5-T system with magnetization transfer imaging and MR spectroscopy of the splenium. Magnetization transfer imaging was also performed in the brain stem in all patients, and other areas of the brain were sampled in one patient. The splenium of the corpus callosum and brain stem were studied because these are often affected by diffuse axonal injury. Scans were obtained 2 to 1129 days after injury (median, 41 days). MTR was considered abnormal if it was more than 2 SD below normal. Proton MR spectroscopy was used to calculate the N -acetylaspartate (NAA)/creatine (Cr) ratio. GOS was determined at least 3 months after injury.

RESULTS: In 10 patients with a GOS of 1 to 4, the mean NAA/Cr was 1.24 ± 0.28; two of these patients had abnormal MTR in normal-appearing white matter (NAWM). In 20 patients with a GOS of 5, the mean NAA/Cr was 1.53 ± 0.37 ( P &lt; .05); four of these patients had abnormal MTR in NAWM. MTR abnormalities in NAWM were identified in six patients, but these changes did not correlate with GOS or MR spectroscopy changes.

CONCLUSION: MTR and MR spectroscopy can quantify damage after TBI, and NAA levels may be a sensitive indicator of the neuronal damage that results in a worse clinical outcome." />
<meta name="og-title" property="og:title" content="Magnetization Transfer Imaging and Proton MR Spectroscopy in the Evaluation of Axonal Injury: Correlation with Clinical Outcome after Traumatic Brain Injury" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/22/1/143" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Current imaging does not permit quantification of neural injury after traumatic brain injury (TBI) and therefore limits both the development of new treatments and the appropriate counseling of patients concerning prognosis. We evaluated the utility of magnetization transfer ratio (MTR) and proton MR spectroscopy in identifying patients with neuronal injury after TBI.

METHODS: Thirty patients with TBI (21–77 years old; mean age, 42 years; admission Glasgow Coma Scale (GOS) scores 3–15; mean score, 11) were studied on a 1.5-T system with magnetization transfer imaging and MR spectroscopy of the splenium. Magnetization transfer imaging was also performed in the brain stem in all patients, and other areas of the brain were sampled in one patient. The splenium of the corpus callosum and brain stem were studied because these are often affected by diffuse axonal injury. Scans were obtained 2 to 1129 days after injury (median, 41 days). MTR was considered abnormal if it was more than 2 SD below normal. Proton MR spectroscopy was used to calculate the N -acetylaspartate (NAA)/creatine (Cr) ratio. GOS was determined at least 3 months after injury.

RESULTS: In 10 patients with a GOS of 1 to 4, the mean NAA/Cr was 1.24 ± 0.28; two of these patients had abnormal MTR in normal-appearing white matter (NAWM). In 20 patients with a GOS of 5, the mean NAA/Cr was 1.53 ± 0.37 ( P &lt; .05); four of these patients had abnormal MTR in NAWM. MTR abnormalities in NAWM were identified in six patients, but these changes did not correlate with GOS or MR spectroscopy changes.

CONCLUSION: MTR and MR spectroscopy can quantify damage after TBI, and NAA levels may be a sensitive indicator of the neuronal damage that results in a worse clinical outcome." />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node1959--5" data-node-nid="1959" id="top-node-1959--6337604085" data-pisa="ajnr;22/1/143" data-pisa-master="ajnr;22/1/143" data-apath="/ajnr/22/1/143.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
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      <h1 class="highwire-cite-title" id="page-title">Magnetization Transfer Imaging and Proton MR Spectroscopy in the Evaluation of Axonal Injury: Correlation with Clinical Outcome after Traumatic Brain Injury</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Grant Sinson</span>, <span class="highwire-citation-author" data-delta="1">Linda J. Bagley</span>, <span class="highwire-citation-author" data-delta="2">Kim M. Cecil</span>, <span class="highwire-citation-author" data-delta="3">Maria Torchia</span>, <span class="highwire-citation-author" data-delta="4">Joseph C. McGowan</span>, <span class="highwire-citation-author" data-delta="5">Robert E. Lenkinski</span>, <span class="highwire-citation-author" data-delta="6">Tracy K. McIntosh</span> and <span class="highwire-citation-author" data-delta="7">Robert I. Grossman</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">January 2001,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">22 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">143-151; </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-1959--6337604085" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Grant Sinson </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Grant%2BSinson%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sinson%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AGrant%2BSinson%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Linda J. 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 22</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 1 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Jan 2001 </div></div>
      
      
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      <div class="highwire-cite-title">Magnetization Transfer Imaging and Proton MR Spectroscopy in the Evaluation of Axonal Injury: Correlation with Clinical Outcome after Traumatic Brain Injury</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Grant</span> <span class="nlm-surname">Sinson</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Linda J.</span> <span class="nlm-surname">Bagley</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Kim M.</span> <span class="nlm-surname">Cecil</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Maria</span> <span class="nlm-surname">Torchia</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Joseph C.</span> <span class="nlm-surname">McGowan</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Robert E.</span> <span class="nlm-surname">Lenkinski</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Tracy K.</span> <span class="nlm-surname">McIntosh</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Robert I.</span> <span class="nlm-surname">Grossman</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2001, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">22 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">143-151; </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Grant</span> <span class="nlm-surname">Sinson</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Linda J.</span> <span class="nlm-surname">Bagley</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Kim M.</span> <span class="nlm-surname">Cecil</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Maria</span> <span class="nlm-surname">Torchia</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Joseph C.</span> <span class="nlm-surname">McGowan</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Robert E.</span> <span class="nlm-surname">Lenkinski</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Tracy K.</span> <span class="nlm-surname">McIntosh</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Robert I.</span> <span class="nlm-surname">Grossman</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2001, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">22 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">143-151; </span></div>
  
  
  
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