Identification of a By-Product of Nitric Oxide Synthase Activity in Human Acute Brain Injury with in Vivo Proton Magnetic Resonance Spectroscopy
Morry Silbersteina,
Dianne Laneb,
Seetal Doddc and
Kenneth Opeskind
a Department of Radiology, the University of Sydney, and the School of Medicine, Monash University, Australia
b Medical Imaging Division, the Canberra Hospital, Australia
c Department of Psychiatry, Austin and Repatriation Medical Centre, Australia
d Department of Pathology, St Vincent’s Hospital, Melbourne, Australia
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FIG 1. In vitro identification of an unknown peak.
A, Note the small triplet (arrow) between the creatine and choline peaks in this magnified section of an MR spectrum obtained in a cerebral cortex specimen.
B, Magnified region of this citrulline spectrum corresponds to the shape and location of the unknown peak.
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FIG 2. In vivo identification of an unknown peak.
A, In vivo spectrum obtained in a healthy volunteer demonstrates the absence of any visible peak between those of creatine and choline.
B, Spectrum from an area of histologically proven radionecrosis in a 22-year-old man demonstrates a small peak centered at 3.15 ppm (arrow).
C, Spectrum from an area of suspected infarction (confirmed at 6-month clinical follow-up) in a 58-year-old woman demonstrates a large citrulline peak between those of creatine and choline.
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