Diffuse Metabolic Abnormalities in Acute Mild Traumatic Brain Injury: A Quantitative Proton MR Spectroscopy Study

Ivan Kirov¹, James Babb¹, Joseph Reaume¹, Robert Grossman¹, Oded Gonen¹

Since injury in mild traumatic brain injury is likely both minimal and diffuse, we used a proton MR spectroscopy (1H-MRS) strategy of both high coverage and sensitivity. To achieve the former, a 3D 1H-MRS volume-of-interest (VOI) covered 360cc of mostly white matter, and whole-brain 1H-MRS accounted for all the brain. For high sensitivity, all 480 spectra of the 3D VOI were summed, yielding one spectrum per subject. Since B0 homogeneity is better across small voxels, spectra alignment before summation resulted in excellent spectral resolution. Results revealed no neuronal dysfunction or atrophy, but diffuse elevation of choline and myo-inositol in the 3D VOI.