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Introduction. The technique of diffusion tensor imaging (DTI) is widely used in brain examination. However, DTI application for examining the spinal cord, especially in children, is not easy: small dimensions of the spinal cord with a typical low signal-to-noise ratio, artifacts from the respiration and pulsation of the heart and large vessels, as well as from swallowing movements. EPI sequences used to obtain diffusion indices cause eddy current distortions.Objective. To study changes in DTI parameters of the spinal cord in children with cervical spinal cord injury.Material and methods. 56 children aged 2–17 years with cervical spine injury (CSI) and 20 children without CSI were examined with Phillips Achieva3 T magnetic resonance scanner. The protocol consisted of sagittal STIR, sagittal and axial T1- and T2WI SE and axial DTI. To assess DTI, the following parameters were calculated: apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial (AD) and radial (RD) diffusion coefficients.Results. By ASIA criteria, 29 (51%) children out of 56 had CSI with neurological complications; 27 (49%) had no complications. Neurological dysfunction of degree A was in 13 patients; B – in 3; C – in 9; D – in 4; E – in 27. Average values of diffusion in patients were: ADC = 0.74 ± 0.12 • 10−3 mm2/s−1, FA = 0.36 ± 0.07, BP = 1.15 + 0.28 • 10−3 mm2/s−1, RD = 0.52 + 0.32 • 10−3 mm2/s−1.Conclusion. DTI can detect changes which cannot be detected by conventional MRI. Low ADC values in the acute injury may indicate spinal cord injury and predict a negative functional outcome.

A kinetic study of the effect of thermoheliox (inhalation of a helium and oxygen mixture, 70 °C) on the functional hemodynamics of the human brain by functional magnetic resonance imaging was carried out. The dynamic responses of the BOLD signal were found to be biphasic. An empirical equation describing the first phase of the hemodynamic response to visual stimulus was proposed. It was shown that preliminary inhalation of thermoheliox stimulates the hemodynamic responses by slowing down the vasoconstriction.

Introduction. The frequency of osteomyelitis in pediatric population is approximately 1:5000, and the mortality rate is from 0.2% to 17.0%. In children, acute bone infection is most often of hematogenous origin. Transition from the classical radiography and radionuclide examination to computed tomography (CT) and magnetic resonance imaging (MRI) has been completed.Purpose. To demonstrate potentials of CT and MRI in the diagnostics of osteomyelitis in children.Material and methods. 238 children with osteomyelitis, aged 1-17 years (average 9.1 ± 4.9 years), were examined for the last ten years. There were 126 boys (53%) and 112 girls (47%). Depending on the disease nosology, patients were divided as follows: hematogenous osteomyelitis (n = 112 children, 47%), BCG-osteomyelitis (n = 20, 8.4%), post-traumatic osteomyelitis (n = 67, 28.2%). 138 children (58%) were treated surgically. CT scanning was performed in 174 patients using Brilliance 16 scanners. MRI was performed using Philips AchievadStream 3.0 T scanner to obtain multi-planar STIR, T1-, T2- and PD weighted images (SE and GE). In addition, new MRI methods were used: diffusion-weighted images (DWI), Dixon, dynamic MRI with contrast enhancement (DCE).Results. CT examination, which was performed in 174 patients at the same terms as radiography, confirmed density decrease ( though not large). Periosteal changes were better visualized at CT examination in 107 out of 174 patients (61.5%) including those who had changes at the classical radiography. MRI was performed in 51 patients ( including those with intravenous contrast enchancement) on Day 2-3 since the disease onset. This examination was effective in all cases (sensitivity 100%). T2WI and STIR with fat suppression (FS) clearly revealed edema of the bone marrow and surrounding muscles as well as small changes.Conclusion. MRI is the most informative diagnostic technique in acute osteomyelitis at its early period because main signs of the initial stage of this disease - edema of bone marrow, periosteum and soft tissues - are detected during the first days. In addition, MRI reveals details of bone and soft tissues damages, including abscess and sequester formation, especially in spinal and pelvic lesions. MRI sensitivity in osteomyelitis reaches up to 100%. Sequences with the fat suppression (FS) can better detect bone marrow edema and inflammation than radiography. MRI is a preferable technique in diagnostics of infectious lesions of the spine, pelvis, and limbs.

The objective was to assess the capabilities of MRI and CT in visualizing free bone and cartilage fragments in the knee cavity after lateral dislocation of the patella. Materials and methods. CT and MRI were performed in 220 patients, including 127 girls and 93 boys aged 12 to 18 years (mean age 14.5 years), with acute lateral patellar dislocation. Results. Lateral dislocation of the patella in 25% of cases led to the appearance of osteochondral fragments. CT scan revealed and confirmed osteochondral fragments surgery in 55 people (100%), MRI scan - in 50 people (90%). The sites of the detachment of the osteochondral fragments were: a medial facet of the patella in 22 (38.8%), the outer edge of femur lateral condyle in 33 (58.2%), t patella and lateral condyle of the femur in 2 patients (3%). Free cartilage fragments not detected by CT were detected by MRI in 2 patients. Conclusion. Patellar dislocation is an injury that is likely to require surgery. The volume of osteochondral and soft tissue lesions can be established with the maximum degree of probability by MRI while detecting small osteochondral fragments is most reliable with CT. Combining these two observation methods provides the complete possible information about the extent of damage, which allows timely resolution of treatment tactics.

Introduction. In MRI, the difference in sensitivity between tissues is used to obtain images weighted by the inhomogeneity of the magnetic field termed susceptibility-weighted imaging (SWI) and a high-resolution 3D radiofrequency gradient echo scan with full speed compensation is applied. The aim was to determine the features of lesions caused by traumatic brain injury in children using the SWI sequence. Materials and methods. 535 TBI children aged two months up to 18 years old (average age 9.58 ± 1.5) were studied. There were 325 boys (60.7%), 210 girls (39.3%). MRI was performed without and with intravenous contrast on a Phillips Achieva 3 T scanner with T1- and T2WI, 2D and 3D images, FLAIR, magnetic resonance angiography (TOF MRA), SWI, and DW/DTI, MRS and fMRI, SWI were used for visualization of DAI. Results. Patients included children with severe TBI - 178 (33.3%), moderate TBI - 172 (32.1%) and mild TBI - 185 (34.6%). Of the 535 injured children, 129 (24.1%) had MRI performed within the first 24 hours from the moment of injury, up to 48 hours - at 91 (17.0%), up to 72 hours - in 78 (14.6%) and up to 13 days - in 237 (44.3%). DAI foci at all degrees of TBI were detected in 422 (78.9%) children out of 535 children. Conclusion. SWI is a sensitive method for diagnosing brain lesions in TBI and significantly contributes to predicting outcomes in the early stages after trauma. The amount of brain lesions diagnosed by SWI correlates with the degree of injury according to the Glasgo Coma Scale. The study of the brain functional connections can inform about possible relationships between the localization of the SWI lesion and cognitive deficits, potentially providing an opportunity to use SWI in the hyperacute phase.

Introduction. Fractures of pelvic bones in children are rare and make up from 0.3 to 4% of all childhood trauma, 20% of children with polytrauma have pelvic ring injuries. Comparative studies of diagnostic capabilities of MRI and CT in sacral and acetabular fractures showed that about 37% of CT were missed, therefore the authors recommended MRI as the best method in visualizing pelvic fractures.Aim of this study is to show the capabilities of CT and MRI to improve recognition of pelvic fractures.Material and methods. In the period 2010–2019, 790 children with pelvic fractures as part of polytrauma were studied. The age of children was from 8.5 to 17 years, average 10.14 ± 1.4. Computed tomography with three-phase contrast was performed in all 790 patients on Brilliance 16 scanners. MRI was performed (n = 63) on a 3 T tomograph with obtaining multiplanar STIR, T1-, T2- and PD weighted images (VI) with signal suppression factor of adipose tissue, as well as 3D isotropic images.Results. On the polytrauma severity scale (ISS), the assessment of the condition of 790 children ranged from 23.54 to 27.5 (mean 25.77) points. The main mechanism of pelvic injury was road traffic accidents (pedestrian + passenger – 63.54% (n = 502), catatrauma was in second place – 32.66% (n = 258), followed by compression – 2.15% (n = 17) , sports injury – 0.38% (n = 3), other injury – 3.43% (n = 27). 73.26% (n = 578) had multiple pelvic fractures, 20.5% (n = 162) – complicated, – 22.3% (n = 176) unstable In 63 patients with damage to the anterior pelvic ring, according to CT, MRI revealed fractures of the posterior pelvic ring in 79.36% (n = 50).Conclusion. Children with polytrauma must undergo computed tomography to exclude not only all non-muscular-skeletal injuries, but also combined pelvic fractures. We believe that for the detection and assessment of bone fractures and concomitant injuries of other tissues and organs of the pelvis, in most cases, multiphase CT with intravenous contrast is a sufficient method. MRI is important for evaluating pelvic soft tissue structures such as tendons, ligaments, nerves and fascia, as well as detecting hidden / fine bone lesions.

To measure N-acetyl aspartyl glutamate (NAAG) and N-acetyl aspartate (NAA) concentrations in visual cortex activated by a continuous stimulation in a 3 T field. NAAG and NAA spectra were obtained with MEGA-PRESS pulse sequence (TE/TR = 140/2000 ms; δONNAAG/δOFFNAAG = 4.61/4.15 ppm; δONNAA/δOFFNAA = 4.84/4.38 ppm) in 14 healthy volunteers at rest and upon stimulation by a radial checkerboard flickering at a frequency of 8 Hz. Spectra of all subjects were frequency and phase aligned and then averaged. Additionally, to obtain the time-dependency data, spectra were divided into time sections of 64 s each. The intensities of NAA, NAAG and lactate + macromolecular (Lac + MM) signals were defined by integration of the real part of spectra. The heights of the central resonance of NAAG and NAA signals were measured. The NAAG and NAA concentrations, measured with 2.5% and 0.5% error, respectively, were unaffected by visual activation. A significant increase in the Lac + MM signal by ~ 12% is clearly observed. No stimulation-induced time dependency was found for NAAG or NAA, while the increase in Lac + MM was gradual. The concentration values in visual cortex are in good agreement with the 7 T MRS measurements: [NAAG] = 1.55 mM, [NAA] = 11.95 mM. The MEGA-PRESS pulse sequence together with the spectral preprocessing techniques allowed to demonstrate that the concentrations of NAAG and NAA in the visual cortex remain constant during continuous visual stimulation within the margin of error. An increase in the lactate signal intensity signifies the activation of the anaerobic glycolysis in activated visual cortex.

Introduction. The number of acute and stressful injuries has been increasing in recent years. Injuries of the musculoskeletal system in children seeking emergency care account for 41%, while children aged from 5 to 17 years with chronic sports injuries account for 53% who need medical attention. The lower extremity is the most frequently affected part of patients aged from 5 to 18 years, which is about 60% of all injuries. Aim of the study. To show the possibilities of magnetic resonance imaging in the diagnosis of sports injuries of lower extremities in children. Materials and methods. MRI was performed on a scanner with a magnetic field strength of 3 T to obtain multi-planar STIR, T1-, T2- and PD-weighted images (WI) SE and GE in axial, oblique frontal and sagittal projections with a slice thickness of 4 mm, as well as 2D and 3D isotropic images that were used to obtain images with contrast gain. Specialized coils were used for MRI. MRI was performed in case of damage to the hip (n = 19), knee (n = 329), and ankle joints (n = 32). Results. Studies of the hip were limited to sports muscle injury - muscle strain due to forced contractile load (75.8%) and muscle bruises (24.2%). According to the MRI results, 320 children with knee injury were diagnosed with ACL ruptures, in 67% - complete (n = 214), 33% (n = 106) - partial. Eight (3.7%) of 214 athletes had isolated full breaks in ACL; the remaining 206 were associated with damage to other structures of the knee joint. ACL ruptures were accompanied in all 320 cases of hemarthrosis. Of 30 patients with an ankle injury, 17 had an anterior talofibular ligament (56.7%), in 8 cases with an avulsion of bone fragments from the lateral ankle. Partial deltoid ligament injuries were detected in 9 patients (30.0%); complete ruptures were rare and were observed in only two patients (6.7%). Conclusion. Among imaging methods, MRI plays a decisive role in the diagnosis of sports injuries in children.

Mild traumatic brain injury (mTBI) is the most common neurological damage in children that's why it is extremely important to identify and analyze biomarkers that can help in predicting patient's treatment and recovery in period of mTBI. Aim of this study is to verify a hypothesis that functional connectivity disturbances between intact cerebellum and DMN nodes are included in symptomatic manifestation of mTBI.Methods. 28 MR negative patients with mTBI were studied in age from 12 to 17 years (mean age – 14.7 years). The control group consisted of 23 healthy children. All MRI studies wereperformed on a Philips AchievadStream 3.0 T scanner equipped with a 32-channelPhilips dStream head coil. A 4 min rsfMRI gradient-echo echo planar imaging (EPI)sequence was acquired (TR = 3000 ms, echo time (TE) = 30 ms, 80 dynamics withdynamic scan time = 3 s). fMRI data were processed using functional connectivitytoolbox CONN.Results. No statistically significant differences in correlation strengths between control group and group of patients were detected as a result of DMN analysis. Intergroup seed-basedcorrelation ROI analysis revealed statistically significant (p < 0.05) differencein links between DMN regions and vermis (cerebellum): positive link in control group and negative link in groupof patients.Conclusions. The revealed changes in DMN neuronal connection and cerebellar regions in acute stage of mTBI patients can be an initial step of damages leading to cognitive deficit which can be developed in future.

Purpose To separately measure N-acetyl aspartul glutamate (NAAG), N-acetyl aspartate (NAA), aspartate (Asp), and glutamate (Glu) concentrations in white matter (WM) using J-editing techniques in patients with mild traumatic brain injury (mTBI) in the acute phase. Methods Twenty-four patients with closed concussive head injury and 29 healthy volunteers were enrolled in the current study. For extended 1 H MRS examination, patients and controls were equally divided into two subgroups. In subgroup 1 (12 patients/15 controls), NAAG and NAA concentrations were measured in WM separately with MEGA-PRESS (echo time/repetition time [TE/TR] = 140/2000 ms; δ ON NAA / δ OFF NAA = 4.84/4.38 ppm, δ ON NAAG / δ OFF NAAG = 4.61/4.15 ppm). In subgroup 2 (12 patients/14 controls), Asp and Glu concentrations were acquired with MEGA-PRESS (TE/TR = 90/2000 ms; δ ON Asp / δ OFF Asp = 3.89/5.21 ppm) and TE-averaged PRESS (TE from 35 ms to 185 ms with 2.5-ms increments; TR = 2000 ms) pulse sequences, respectively. Results tNAA and NAAG concentrations were found to be reduced, while NAA concentrations were unchanged, after mild mTBI. Reduced Asp and elevated myo-inositol (mI) concentrations were also found. Conclusion The main finding of the study is that the tNAA signal reduction in WM after mTBI is associated with a decrease in the NAAG concentration rather than a decrease in the NAA concentration, as was thought previously. This finding highlights the importance of separating these signals, at least for WM studies, to avoid misinterpretation of the results. NAAG plays an important role in selectively activating mGluR3 receptors, thus providing neuroprotective and neuroreparative functions immediately after mTBI. NAAG shows potential for the development of new therapeutic strategies for patients with injuries of varying severity.

Introduction. MDCT is more sensitive in pulmonary, pleural and bone injuries detection in patients with polytrauma than chest radiography. High-quality multiplanar reconstructions brought additional information to the diagnostic capabilities of this method. Purpose. Purpose of this publication was to analyze the data obtained during chest MDCT in children with polytrauma. Material and methods . 147 children aged from 6 months to 17 years with polytrauma and chest injuries were studied. MDCT was performed on Philips Brilliance CT 16 and 64. Results . We retrospectively evaluated CT and clinical data of 147 patients, the main reason of polytrauma were traffic accidents (n = 91 – 61.9%), the rest was caused by fall from a height (56 – 38.1%). In 80% of cases the injury was severe and complex with not only lungs and chest damage, but also with other parts of the body: the head, the stomach, the pelvis and the limbs. Among 147 patients, pulmonary parenchyma damages in the form of injuries, less gaps, were detected in 70% of cases, pneumothorax – in 30% of cases, hemothorax – in 15%. Conclusion . MDCT significantly improves the detection of pulmonary damage in blunt thoracic trauma due to better visualization of bone, soft tissues and blood vessels damage and the possibility of obtaining multiplanar image reconstructions. MDCT allows to identify lung contusions and to differentiate areas of atelectasis and tears, to evaluate and calculate their volumes, and therefore should always be used as a primary imaging method in patients with polytrauma.

Wide-spread visualization methods which are computed tomography (CT) and magnetic resonance imaging (MRI) are not sensitive to mild traumatic brain injury (mTBI). However, mTBI may cause changes of cerebral microstructure that could be found using diffusion-tensor imaging. The aim of this study is to reveal the impact of acute mTBI (no more than 3 days after trauma) on diffusion parameters in corpus callosum, corticospinal tract, and thalamus in children (aged 14–18). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were analyzed. Significant increase in FA and decrease in ADC were observed in thalamus. The trend to an increase in FA is observed in corpus callosum.

Treatment of patients with severe traumatic brain injury is very expensive. The main problem of medical care with its adaptation to neurological outcomes is the choice of diagnostic techniques as predictive tools that reliably predict long-term neurological and psychological outcomes. The extended range of magnetic resonance techniques, including SWI, diffusion-weighted and diffusion-tensor images (DWI / DTI), magnetic resonance spectroscopy (MRS) and functional magnetic resonance imaging allows to identify not only anatomical, but also functional brain damage. In the review, the authors discuss the latest information on visual and quantitative assessment of abnormalities in patient with TBI; new understanding and clinical significance of various MRI methods are shown as well. The authors define new biomarkers and their potential for predicting TBI outcomes. Several combined modalities not only provide better understanding of major physiological changes in patients with TBI, but they also improve diagnostic accuracy in outcome predicting. The present review is a summary of some important researches published recently.

—Gamma-aminobutyric acid (GABA) is the main inhibitory neurotransmitter in the brain; it plays an important role in various types of synaptic plasticity and pathology. In the present work, proton magnetic resonance spectroscopy (1H-MRS) and two modified MEGA-PRESS pulse sequences, that is, –GABAMEGA-PRESS and +GABAMEGA-PRESS, were used to investigate the effect of visual stimulation on the GABA level in the human visual cortex in vivo. With –GABAMEGA-PRESS, it was possible to acquire the 1H-NMR signal of methylated protons of GABA with the chemical shift δ = 3.01 ppm without the signals from macromolecules. When +GABAMEGA-PRESS was used, the GABA signal was a superposition of resonances of methylene protons of GABA and macromolecules. The effect of constant visual stimulation on the level of N-acetylaspartate and total level of glutamate and glutamine was also estimated. Constant visual stimulation had no effect on the levels of N-acetylaspartate and glutamine in the visual cortex. The –GABA signal intensity decreased with a statistically significant decrease in the level of GABA signal intensity leading to inactivation of GABA synthesis. No statistically significant changes in the intensity of the +GABA resonance were found, probably due to the effect of visual stimulation on macromolecules. In order to test this hypothesis, a signal from macromolecules was acquired using a specifically designed inversion-recovery pulse sequence. It was shown that the intensity of this signal is unaffected by visual stimulation and the absence of changes in the intensity of the +GABA signal during the stimulation has to be considered as the masking effect of macromolecular signal.

A kinetic model of the process response of nervous tissue to an external signal stimulus is proposed. The model is based on the multistage and non-linear nature of the dynamic process of changes of N-acetylaspartate concentration. The existence of multiple steady states explains the trigger effect of the system. The effect of substrate inhibition for this system was studied as a necessary factor of N-acetylaspartate’s autostabilization as a key metabolite in the brain. The appearance of N-acetylaspartate’s “anti-peak” causes a wave of its hydrolysis products, such as aspartic acid and acetic acid.

Previously using 31P magnetic resonance spectroscopy (MRS) we have demonstrated that one hyperbaric oxygenation (HBO) session (with O2 pressure 1.2 atm) directly activates cerebral energetics: the decrease in creatine phosphate (PCr) and, possibly, the increase in nicotinamide adenine dinucleotide. The aim of this study is to elucidate the effect of one HBO session on the concentrations of metabolites detectible by 1H MRS, and on the connectivity in Default Mode Network. Absolute concentrations of the metabolites were calculated. The reduction of N-acetyl aspartate by 3% was found in mediolateral prefrontal cortex (MPFC) with p

Intracellular concentrations of N acetyaspartate (NAA), aspartate (Asp) and glutamate (Glu) were determined for the first time in human brain in vivo, and the effect of severe traumatic brain injury on NAA synthesis in acute and late post-traumatic period was investigated. In MRI‑negative frontal lobes one day after injury Asp and Glu levels were found to decrease by 45 and 35%, respectively, while NAA level decreased by only 16%. A negative correlation between NAA concentration and the ratio of Asp/Glu concentrations was found. In the long-term period, Glu level returned to normal, Asp level remained below normal by 60%, NAA level was reduced by 65% relative to normal, and Asp/Glu ratio significantly decreased. The obtained results revealed leading role of the neuronal aspartate-malate shuttle in violation of NAA synthesis.

For the first time the intracellular concentrations of N-acetylaspartate (NAA), aspartate (Asp), and glutamate (Glu) were measured in human brain in vivo, and the effect of severe traumatic brain injury on NAA synthesis in acute and remote posttraumatic phases was revealed. In non-damaged (MRI-negative) lobes the next day after injury, Asp and Glu decreased by 45% and 35%, respectively, while NAA decreased only by 16%. A negative correlation between NAA and Asp/Glu ratio was found. The Glu level returned to the norm long after injury, Asp remained below the norm by 60%, NAA decreased by 65% relative to the norm, and Asp/Glu decreased significantly. The results obtained educe the leading role of neuronal aspartate-malate shuttle in NAA synthesis alterations.

Blunt abdominal trauma is one of the leading causes of the morbidity and mortality in all age groups. Among all the causes of deaths due to injury, abdominal damage accounted of about 10%, and in children - 8.5%. Timely imaging takes a key place in assessing abdominal injury in traumatized children. Computer tomography (CT) is a method of visualization that allows recognize and evaluate characteristic signs of the traumatic damage in hemodynamically stable children. Modern multislice spiral computer tomographs (MSCT) provide high quality of the image due to the improvement of both scanning methods and post-processing facilities. Currently, CT allows most accurately detect lesions of parenchymal and hollow organs, as well as reveal and quantify intraperitoneal and extraperitoneal fluid and blood. In addition, CT has an exceptional sensitivity in the diagnosis of the combined trauma of various organs and systems. The use of CT as the main screening method for the examination of traumatized children along with the improvement of maintenance therapy plays a crucial role in the success of the not operative treatment of trauma to parenchymatous organs. The rapid assessment of the state of traumatized children according to CT findings also contributed to the decline of the incidence of complications and mortality rate. The decision about surgical intervention in a small number of children in need of surgical treatment is primarily made on the basis of clinical criteria, not CT results. Thus, CT mainly determines non-operative decisions regarding, for example, duration of hospitalization, intensity of care and limitation of the activity. In this paper, we propose a standardized CT technique and the main symptomatology that determines the severity of the damage of abdominal organs in children, based on own experience, taking into account the world literature data on CT.

Wide-spread visualization methods which are computed tomography (CT) and magnetic resonance imaging (MRI) are not sensitive to mild traumatic brain injury (mTBI). However, mTBI may cause changes of cerebral microstructure that could be found using diffusion-tensor imaging. The aim of this study is to reveal the impact of acute mTBI (no more than 3 days after trauma) on diffusion parameters in corpus callosum, corticospinal tract, and thalamus in children (aged 14-18). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were analyzed. Significant increase in FA and decrease in ADC were observed in thalamus. The trend to an increase in FA is observed in corpus callosum.

Bone mineral density is an important parameter that determines strength of the bone. Decrease in bone mineral density (BMD) leads to dangerous skeletal diseases like osteopenia, osteoporosis and an increased risk of fractures, for instance compression vertebral fracture (CVF). Dual-energy x-ray absorptiometry (DXA) and quantitative CT (QCT) are commonly accepted methods for assessing of the BMD. Previously FF was shown to increase in adult patients with osteoporosis as compared to healthy volunteers. The aim of the study was to explore the relationship between FF and BMD in children. Correlation analysis revealed significant inverse correlation link (p1H MRS could be good alternative to QCT and DXA without radiation dose in osteoporosis detection. Revealed significant negative correlation between FF and BMD in children without osteoporosis suggests that the processes of increasing FF in the bone marrow and lowering the BMD are parallel. Therefore, 1H MRS could be good alternative to QCT and DXA without radiation dose in osteoporosis detection.

The aim of this study is to elucidate the effect of one HBO session on the concentrations of metabolites detectible by 1H and 31P magnetic resonance spectroscopy. An activation of energy metabolism that manifested in the decrease of creatinephosphate (PCr), pHint and increase α-ATP signal after a HBO session is revealed. Other ATP resonances remain unchanged. Also the reduction of N-acetyl aspartate by 3% in mediolateral prefrontal cortex (MPFC) with p2.

For the first time the intracellular concentrations of N-acetylaspartate (NAA), aspartate (Asp), and glutamate (Glu) were measured in human brain in vivo, and the effect of severe traumatic brain injury on NAA synthesis in acute and remote posttraumatic phases was revealed. In non-damaged (MRI-negative) lobes the next day after injury, Asp and Glu decreased by 45% and 35%, respectively, while NAA decreased only by 16%. A negative correlation between NAA and Asp/Glu ratio was found. The Glu level returned to the norm long after injury, Asp remained below the norm by 60%, NAA decreased by 65% relative to the norm, and Asp/Glu decreased significantly. The results obtained educe the leading role of neuronal aspartate-malate shuttle in NAA synthesis alterations.

IntroductionThe aim of the study was to analyze the microstructural and metabolic features of the corpus callosum in recently onset schizophrenia.Objectives13 young (17–28 years old) male patients with recently onset schizophrenia (F20, ICD-10) and 15 sex and age matched mentally healthy subjects were examined.Methods3 T Philips Achieva scanner with 8-channel SENSE coil was used. DTI was conducted with EPI SENSE (TR = 9431 ms; TE = 70 ms). The values of diffusion coefficient (ADC), fractional anisotropy (FA), radial (RD) and parallel (PD) diffusivity were calculated using workstation Philips EBWS 2.6.3.4. Spectroscopic voxel (2 × 1 × 1 cm) was placed consequently in the corpus callosum genu and splenium. PRESS (TR/TE = 1500/40) was used.ResultsIn patients, increased ADC (P = 0.02) and RD (P = 0.008), decreased FA (P = 0.008) and NAA (P = 0.03) were found in the corpus callosum genu, No intergroup differences by PD, Cho, Cr, Glx were found in this area. Also, no statistically significant intergroup differences were observed for the DTI and MRS characteristics of the corpus callosum splenium.ConclusionsIt has been shown that RD increase is associated with demyelination process. So, an increase of RD in the present study could reflect demyelination in CC genu. Cells membranes abnormalities should lead to an increase of Cho which was not found. NAA reduction could be caused by reduction of axonal integrity. The latter process is considered to precede demyelination and not to be accompanied by PD rise. Thus, the present study revealed axonal integrity reduction and low demyelination in the genu of the corpus callosum in the early stages of schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The MEGA-PRESS pulse sequence was used for determination of overlapping signals in the (1)H-MRS spectra of the human brain. For the first time, the balance of GABA glutamate/glutamine concentrations was estimated quantitatively in the human brain of patients with ultra-high risk of schizophrenia. It was found that GABA concentration and GABA/GLX ratios were significantly reduced in the left frontal lobe of UHR subjects.

IntroductionThe aim of this study was the analysis of dynamics of motor cortex metabolite in the norm and in early stage of schizophrenia in period of BOLD response to event related single stimulus.ObjectivesThe patients group consisted of 9 mails of 16–28 years old in initial stage of schizophrenia and in remission. The group of 9 age matched healthy mails was used as a control.MethodsPhillips Achieva 3.0 T scanner was used for the study. Volume of interest in motor cortex was localized on the base of fMRI. 1Н МR spectra were run using synchronization of FID signals acquisition (PRESS, TE = 30 ms TR = 3000 ms) with dynamics of BOLD response at the same paradigm.ResultsThe BOLD signal in both groups demonstrated maximum at the 6th s after target stimulus, however its value was reliably lover in schizophrenia in comparison with the control. The only [NAA] in normal motor cortex was changed after stimulation. The stable values of [NAA], [Cr] and [Cho] were observed in dynamic of resting state as well. [NAA] in normal cortex statistically significantly decreased at the 12th s after stimulus presentation and returned to initial value at the 15th s.ConclusionDifferent behavior of [NAA] in the norm and schizophrenia might be related with a difference in location (or activity) of aspartoacylaze (ASPA). Decreased expression of glutamate transporters in schizophrenia could also reduce consumption of NAA as a source of acetate in synthesis of AcCoA which is used for restoration of ATP.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Introduction31P MRS is a unique way of in vivo energy metabolism research. This method allowed revealing schizophrenia-induced disturbances of energy exchange in resting state [1]. We use 31P MRS in presence of visual stimulation that allows neuronal energy-consuming processes studying.ObjectiveRevealing of stimulation effects on high-energy phosphates (PCr, ATP) in early-stage schizophrenia.AimDiscovery of energy processes contribution in schizophrenia pathogenesis.MethodsTwelve right-handed 18–26 years old male patients with early-staged schizophrenia (F20, ICD-10) and 20 age-matched healthy right-handed controls. Spectra were acquired on Philips Achieva 3.0 T using Rapid Biomed 31P/1H birdcage coil and 2D ISIS pulse sequence. fMRI was used for accurate 2D slice positioning, spectroscopy voxels containing primary visual cortex (V1) were averaged (see Fig. 1). Two 31P spectra of V1 were obtained: firstly in resting state and then during 6 minutes of continuous stimulation by 6 Hz flashing checkerboard. Spectra were processed in jMRUI.ResultsExcitation reduced PCr in the norm and had no effect on schizophrenia (see Fig. 2). No excitation-induced ATP changes in both groups were revealed.ConclusionAlteration in PCr behavior in this study witnesses for deviations in energy-consuming processes in schizophrenia. A new scheme of neuronal response to stimulation in schizophrenia is offered.Disclosure of interestThe authors have not supplied their declaration of competing interest.