Prognostic value of magnetic resonance spectroscopy in patients with diffuse axonal injury: a systematic literature review

Abstract

Introduction: Magnetic resonance spectroscopy (MRS) is an imaging technique that provides spectroscopic information about changes in biological markers. Studies suggest that MRS can be helpful in determining the prognosis of patients with diffuse axonal injury (DAI).Methods: The PubMed and Scopus databases were systematically searched in June 2015 using following search strategy: (“Magnetic resonance spectroscopy” OR MRS OR “MR spectroscopy”) AND [(“Diffuse axonal injury” OR DAI] AND Prognosis) to find relevant articles in which the prognostic value of MRS had been investigated in patients with traumatic DAI. All relevant information was extracted from the identified articles and used to synthesize the data for the purpose of this study.Result: In total, 19 articles were found in PubMed and 151 in Scopus. Of these, eight documents were selected for further data extraction following the application of the inclusion/exclusion criteria. The total number of patients who participated in the research studies described in the selected documents was 197. All of the selected documents showed that MRS can be used to quantitatively assess metabolite changes in patients with DAI.Discussion: The results of the studies indicate that MRS imaging as a sensitive method can quantitatively determine even small variations in metabolites. Any changes in the metabolite level of the brain after traumatic injury may be a useful predictor of a patient’s outcome; therefore, if the sensitivity of MRS is proven, this method can have prognostic value when employed with patients with DAI.Conclusion: Based on the results of this systematic review, MRS is a sensitive tool that is helpful in determining the prognosis of patients with DAI.