title: Global and depth resolved phosphorus magnetic resonance spectroscopy to predict outcome after birth asphyxia.
abstract: Twelve normal and 32 asphyxiated neonates were studied using global and depth resolved phosphorus magnetic resonance spectroscopy (31PMRS). Eight of the asphyxiated group died or survived with major neurodevelopmental abnormalities. A global phosphocreatinine/inorganic phosphate (PCr/Pi) ratio below the range of values from normal infants predicted adverse outcome after asphyxia with a positive predictive value of 64%, sensitivity 88%, and specificity 83%. Corresponding values for global inorganic orthophosphate/adenosine triphosphate (Pi/ATP) ratios were positive predictive value 88%, sensitivity 96%, and specificity 88%. Spatially localised MRS data, obtained using phase modulated rotating frame imaging, showed cerebral energy metabolism to be more abnormal in deep than superficial regions after birth asphyxia. However, in this population of full term infants none of the regional metabolite concentrations were superior to global data for prediction of outcome.
authors.affiliation: Department of Paediatrics, John Radcliffe Hospital, Oxford.
authors.forename: J
authors.initials: J
authors.lastname: Moorcraft
authors.forename: N M
authors.initials: NM
authors.lastname: Bolas
authors.forename: N K
authors.initials: NK
authors.lastname: Ives
authors.forename: R
authors.initials: R
authors.lastname: Ouwerkerk
authors.forename: J
authors.initials: J
authors.lastname: Smyth
authors.forename: B
authors.initials: B
authors.lastname: Rajagopalan
authors.forename: P L
authors.initials: PL
authors.lastname: Hope
authors.forename: G K
authors.initials: GK
authors.lastname: Radda
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism*; D001238:Asphyxia Neonatorum / Q000150:complications / Q000378:metabolism*; D001921:Brain / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D010710:Phosphates / Q000378:metabolism*; D010725:Phosphocreatine / Q000378:metabolism*; D010758:Phosphorus; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity
chemical_list: D010710:Phosphates; D010725:Phosphocreatine; D010758:Phosphorus; D000255:Adenosine Triphosphate