| [Objective] Acute cerebral infarction is the most common kind of cerebral vascular diseases, and it is always important for neurologists to accurately recognize ischemic penumbra and guide the superearly thrombolysis treatment .In this study,40 cases of acute cerebral infarction and 10 relating diseases which should be differentiated from acute cerebral infarction were collected. Our purpose is to study the changes of metabolite in the acute cerebral infarction by 'HMRS and investigate the value of ischemic penumbra.[ Materials and Methods ] According to the time of attack,40 cases with acute cerebral infarct were divided into four groups:(l)hyeracute group(<12h),n=4;(2)acute group,(>12h,<24h,)n=21;(3)early phase of subacute group( >24h, <72h)n=10;(4)late phase of subacute group(>72h, <7 days),n=5.The normal side was taken as control group. The 10 relating diseases which should be differentiated from acute infarction including 7 cases of astrocytomas , 3 cases multiple sclerosis(MS). All the astrocytomas were proved pathologically, 3 cases MS were proved clinically. Precontrast MRI scan(including sagittal T1-weighted images , coronal T1-weighted images ,axial T1-weighted . T2-weighted images and diffusion-weighted images)were performed in the all cases. Moreover, postcontrast MRI scan were performed in the 7 astrocytomas. PRESS multiple voxel acquisition was made in all cases. The metabolites of NAA, Cr, Cho and Lac were analyzed. The ratio of NAA, Cr, Cho of study group to that of control group were measured, so were the values of NAA/Cr, Cho/Cr of the same side, Lac in the lesion was compared with Cr on the contralateral side as peak height ratios. The NAA/Cr, Cho/Cr of centralregion(the core of the lesion), marginal region(the area located in the outer part of the central region) and peripheral region(referred to the area which was adjacent to the lesion but showed normal appearance on the T2WI) in the lesion were acquired, student t test and ANOVA were used to compare the metabolite ratios, P value less than 0.05 was considered significant.[Results] Detection of Lac, no obvious changes of NAA, Cr and Cho were showed in the hyperacute group(n=4).In acute group(n=21) ,Lac was increased, NAA began to decrease, Cr was slightly decreased and Cho was remained unchanged .In the early phase of subacute group, Lac could still be detected in 7 cases and couldn't be found in 3 cases, NAA and Cr were lowed, Cho was slightly decreased. In the late phase of subacute group, Lac was not detected in one case and the remaining changes were similar to those of early phase in the subacute stage.NAA, Cr, Cho in study group were decreased to (25 + 15) %, (15 + 8) % and (6 + 9) % respectively.The NAA/Cr (the central region of the lesion) of four groups acute cerebral infarction(including hyperacute stage, acute group, early phase of subacute group and late phase of subacute group) were 0.7735 +0.3340, 1.3986 + 0.4099, 1.6671 +0.2868 and 1.8826+ 0.2261 (mean +SD) respectively. It showed statistically significant differences between acute group and late phase of subacute group(P=0.024).The Lac/Cr( the central region of the lesion) of four groups acute cerebral infarction were 0.7771 +0.1650, 0.4791 +0.3976, 0.2487+0.1939 and 0.2383 + 0.1044 respectively. The significant differences were showed in hyperacute group vs early phase of subacute group , hyperacute group vs late phase of subacute group (P<0.05). The Cho/Cr among four groups in acute cerebral infarction showed no statistically significant differences(F=0.479).Lac in the central region was higher than that of marginal region, whereasNAA was on the contrary. NAA/Cr were decreased and Lac/Cr were increased in the group significantly(P<0.001).Detection of Lac and no obvious changes of NAA in the peripheral region were showed in the 4 cases; Lac was present with slightly decreased NAA in 2 cases.In the hyperacute group, the NAA/Cr between central region and marginal region showed significant difference(P<0.001),no difference could be seen between...
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