The Role of Magnetic Resonance Spectroscopy in Acute Stroke and Its Correlation with Stroke Protocol Magnetic Resonance Imaging in a Tertiary Care Hospital in Chennai (Code-T0147)

Introduction: Acute stroke remains a leading cause of mortality and morbidity worldwide. Advanced neuroimaging techniques, including Magnetic Resonance Imaging (MRI) and Magnetic Resonance Spectroscopy (MRS), have revolutionized the evaluation of ischemic and hemorrhagic strokes. MRS provides metabolic insights that complement anatomical imaging, potentially enhancing diagnostic accuracy and management.

Aims and Objectives:

Aim:

To study the role of Magnetic Resonance (MR) spectroscopy of brain in acute stroke and its association with the stroke protocol MR imaging.

Objective:

1. To evaluate metabolite changes within conventionally defined tissue compartments.
2. To correlate the findings of MR Spectroscopy with MR Imaging.
3. To determine the significance of MR Spectroscopy in detection of acute ischaemic stroke.

Methods: A prospective observational study was conducted on patients presenting with symptoms of acute stroke. All participants underwent stroke protocol MRI, including diffusion-weighted imaging (DWI), fluid-attenuated inversion recovery (FLAIR), and T2-weighted imaging. MRS was performed to assess metabolic changes, including lactate, N-acetylaspartate (NAA), and choline levels. Data from MRI and MRS were analyzed for correlation, and their combined diagnostic utility was assessed.

Results: MRS revealed significant metabolic alterations, including elevated lactate and reduced NAA in ischemic regions, which correlated with DWI findings (p < 0.05). In hemorrhagic strokes, increased choline levels were noted, providing insights into tissue disruption. Combined use of MRS and MRI improved diagnostic sensitivity for early ischemic changes compared to MRI alone.

Conclusion: MRS serves as a valuable adjunct to stroke protocol MRI by providing metabolic insights that enhance the detection and characterization of acute strokes. Its integration into routine protocols could improve early diagnosis and guide therapeutic decisions.

Keywords: Acute stroke, Magnetic Resonance Spectroscopy, Stroke protocol MRI, Metabolic changes, Ischemic stroke, Diagnostic imaging.