The Role of Brain Magnetic Resonance Spectroscopy in Acute Stroke and Its Correlation with Stroke Protocol Magnetic Resonance Imaging in a Tertiary Care Hospital in Chennai (Code-T0150)

Introduction: Acute stroke is a leading cause of neurological disability, and early diagnosis is crucial for effective treatment. Magnetic Resonance Imaging (MRI) is widely used to diagnose and classify stroke, but Magnetic Resonance Spectroscopy (MRS) offers additional metabolic insights that can enhance understanding of acute stroke pathology. MRS can detect changes in metabolic compounds that are not visible on conventional MRI, offering potential for early detection and better treatment outcomes.

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 study was conducted on patients diagnosed with acute stroke who underwent both stroke protocol MRI (including DWI, FLAIR, and T2-weighted imaging) and MRS within 24 hours of symptom onset. The metabolic changes observed on MRS, such as lactate, N-acetylaspartate (NAA), and choline, were compared with MRI findings to evaluate their correlation and diagnostic utility.

Results: MRS revealed significant metabolic abnormalities in stroke-affected brain regions, such as elevated lactate and reduced NAA. These findings correlated with DWI abnormalities, suggesting the presence of acute ischemic changes. MRS showed higher sensitivity for detecting ischemic changes in the first few hours of stroke compared to conventional MRI.

Conclusion: Brain MRS provides valuable metabolic information that complements stroke protocol MRI, aiding in the early diagnosis and management of acute stroke. Its use can improve the accuracy of stroke characterization and assist in monitoring treatment response.

Keywords: Acute stroke, Magnetic Resonance Spectroscopy, Stroke protocol MRI, Ischemic changes, Early diagnosis, Metabolic alterations.