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Identification of Staphylococcus aureus Brain Abscesses: Rat and Human Studies with ¹H MR Spectroscopy¹

¹ From the Centre for Infectious Diseases and Microbiology (U.H., T.C.S.) and Department of Radiology (L.G.), University of Sydney at Westmead Hospital, Room 3114, Level 3, ICPMR, Darcy Rd, Westmead, NSW 2145, Australia; Department of Magnetic Resonance in Medicine (U.H., R.A., C.E.M.) and Faculty of Veterinary Science (R.M.), University of Sydney, NSW, Australia; In vivo NMR Group, Max Planck Institute for Neurological Research, Cologne, Germany (U.H.); Institute for Biodiagnostics, National Research Council Canada, Winnipeg, Manitoba, Canada (B.D., R.L.S.); and Department of Radiodiagnosis, Sanjay Gandhi Post-graduate Institute of Medical Sciences, Lucknow, India (R.K.G.). Received May 13, 2004; revision requested July 29; revision received September 15; accepted October 20. Supported by the National Health and Medical Research Council of Australia (grant no. 153805). Address correspondence to U.H. (e-mail: himmelreich{at}mpin-koeln.mpg.de).

View larger version (40K): [in a new window]   Figure 1. Comparison of ex vivo 1H MR spectra from cell cultures of S aureus, animal models, and human pus samples. One-dimensional 1H MR spectra in phosphate-buffered saline made up with deuterium oxide at 360 MHz were obtained from rat brain biopsy and/or pus samples. A, Spectrum from saline-injected controls. B, Spectrum from S aureus brain abscess after 3 days. C, Spectrum from S aureus brain abscess after 8 days. D, Spectrum from S aureus brain abscess after 14 days. E, Spectrum from GBM. F, G, Spectrum from cell suspensions of S aureus from horse blood agar cultures (aerobic, F) and trypticase soy broth cultures (anaerobic, G). H, Spectrum from human pus from an abdominal S aureus abscess. I, Spectrum from human pus from a cerebral S aureus abscess. AA = amino acid residues; ac = acetate; bet = glycine betaine; glc = glucose residues; inos = myo-inositol; lac = lactate; lip = triglycerides; lys = lysine; NAA = N-acetylaspartate; N(CH3)3 = choline-containing compounds and glycine betaine; NCH2 = creatine, phosphocreatine, lysine; tau = taurine.

View larger version (48K): [in a new window]   Figure 2. Confirmation of the resonance assignment of pus from an S aureus abscess in a rat (after 8 days). A, One-dimensional 1H MR spectrum. B, Spin-echo spectrum (echo time, 30 msec). C, Spin-echo spectrum (echo time, 135 msec). D, Two-dimensional {1H, 1H} correlation spectrum. E,{1H, 13C} Heteronuclear single quantum coherence spectrum (optimized to 1JC,H = 130 Hz). Labeled cross-peaks refer to bet = glycine betaine, gly = glycerol residue, lac = lactate, lip = triglycerides, lys = lysine, and tau = taurine. All other labels refer to amino acid residues, abbreviations of which are expanded in the caption of Figure 1.

View larger version (33K): [in a new window]   Figure 3a. Representative in vivo MR images and spectra from patients with cerebral abscesses caused by S aureus and GBM. MR images and spectra were acquired with clinical 1.5-T MR imagers from (a) patient 4, (b) patient 5, (c) patient 1, and (d) a patient with a cystic GBM. Transverse T2-weighted MR images (2200/80) are shown in the top row. MR spectra were acquired from the volume of interest centered within the abscess and outlined on the images. Middle row: stimulated-echo acquisition sequence (3000/20 or 30). Bottom row: point-resolved MR spectroscopy sequence (3000/135). Volume of interest, 8–12 cm3.

View larger version (34K): [in a new window]   Figure 3b. Representative in vivo MR images and spectra from patients with cerebral abscesses caused by S aureus and GBM. MR images and spectra were acquired with clinical 1.5-T MR imagers from (a) patient 4, (b) patient 5, (c) patient 1, and (d) a patient with a cystic GBM. Transverse T2-weighted MR images (2200/80) are shown in the top row. MR spectra were acquired from the volume of interest centered within the abscess and outlined on the images. Middle row: stimulated-echo acquisition sequence (3000/20 or 30). Bottom row: point-resolved MR spectroscopy sequence (3000/135). Volume of interest, 8–12 cm3.

View larger version (32K): [in a new window]   Figure 3c. Representative in vivo MR images and spectra from patients with cerebral abscesses caused by S aureus and GBM. MR images and spectra were acquired with clinical 1.5-T MR imagers from (a) patient 4, (b) patient 5, (c) patient 1, and (d) a patient with a cystic GBM. Transverse T2-weighted MR images (2200/80) are shown in the top row. MR spectra were acquired from the volume of interest centered within the abscess and outlined on the images. Middle row: stimulated-echo acquisition sequence (3000/20 or 30). Bottom row: point-resolved MR spectroscopy sequence (3000/135). Volume of interest, 8–12 cm3.

View larger version (39K): [in a new window]   Figure 3d. Representative in vivo MR images and spectra from patients with cerebral abscesses caused by S aureus and GBM. MR images and spectra were acquired with clinical 1.5-T MR imagers from (a) patient 4, (b) patient 5, (c) patient 1, and (d) a patient with a cystic GBM. Transverse T2-weighted MR images (2200/80) are shown in the top row. MR spectra were acquired from the volume of interest centered within the abscess and outlined on the images. Middle row: stimulated-echo acquisition sequence (3000/20 or 30). Bottom row: point-resolved MR spectroscopy sequence (3000/135). Volume of interest, 8–12 cm3.