Prognostic value of magnetic resonance spectroscopy in patients with diffuse axonal injury: systematic review of the literatures

Introduction: Magnetic resonance spectroscopy (MRS) is an imaging technique that provides spectroscopic information about the changes of biological markers. Studies suggest that MRS can be helpful in the prognosis of patients with diffuse axonal injury (DAI). Methods: PubMed and Scopus as two major databases were systematically searched in June 2015 by 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. Necessary information were extracted and used for data synthesis based on the purpose of this study. Results: Of total 19 articles found in PubMed and 151 found in Scopus, 8 documents were selected for data extraction in several steps of article selection according to inclusion/exclusion criteria. Total number of patients participated in the selected documents was 197. All of the selected documents showed that MRS can be used for quantitative analysis of metabolite changes in patients with DAI. Discussion: Theresults of studies show that MRS imaging as a sensitive method can quantitatively determine even small variation of metabolites. Since any changes in metabolite level of the brain after traumatic injury may be useful in the prediction of patient’s outcome; therefore, if such sensitivity of MRS is proven, this method can have prognostic value in patients with DAI. Conclusion: Based on the results of included articles, MRS as a sensitive tools is helpful in the prognosis of patients with DAI