MR imaging, MR angiography, and MR spectroscopy of the brain in eclampsia.
OBJECTIVE
To compare the MR imaging and MR angiographic changes with in vivo proton MR spectroscopic findings and to determine the spectral differences between edema and ischemia in patients with eclampsia.


METHODS
Spin-echo MR imaging, MR angiography, and single-voxel proton MR spectroscopy were performed in 10 patients with eclampsia. MR studies were obtained within 3 to 5 days of diagnosis and repeated after 2 weeks with identical parameters.


RESULTS
Multifocal subcortical/cortical hyperintensities were noted in all 10 patients on T2-weighted images; in two patients, hyperintensities were seen in both cerebral hemispheres. In nine patients, MR angiograms showed narrowing of the major vessels constituting the circle of Willis that resolved after 2 weeks. In one patient with subtle imaging changes, MR angiography showed mild bilateral narrowing of the proximal middle and posterior cerebral arteries that did not change after 2 weeks, whereas imaging abnormalities worsened. Findings at single-voxel MR spectroscopy of the reversible T2 hyperintense lesions were significantly different from findings in the control group for N-acetylaspartate (NAA)/creatine ratios. One patient with mild abnormalities at MR imaging and MR angiography had lactate and decreased creatine and NAA, and on a follow-up study had a further decrease of NAA and creatine as well as a decrease in lactate.


CONCLUSIONS
In vivo proton MR spectroscopy may help to differentiate cerebral edema from ischemia in patients with eclampsia and thus may help to determine the prognosis for these patients.
Sengar
A R
AR
Department of Obstetrics and Gynecology, KG Medical College, Lucknow, India.
Gupta
R K
RK
Dhanuka
A K
AK
Roy
R
R
Das
K
K
D000293:Adolescent; D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000098:blood supply* / Q000473:pathology; D001929:Brain Edema / Q000175:diagnosis / Q000503:physiopathology; D002545:Brain Ischemia / Q000175:diagnosis / Q000503:physiopathology; D002536:Cerebral Arteries / Q000473:pathology; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D004461:Eclampsia / Q000175:diagnosis* / Q000503:physiopathology; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D007744:Obstetric Labor Complications / Q000175:diagnosis / Q000503:physiopathology; D011247:Pregnancy; D011379:Prognosis
D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline